[Early recognition of speech and speech-associated disorders after acute stroke]

In the course of increasing demands in acute stroke care in stroke units, criteria for efficient speech diagnosis, which can be applied in the first hours of acute stroke are necessary. In this study we investigated early recognition of speech and speech-associated disorders in acute stroke, and compared the neurologists' clinical diagnoses at admission with the results of a test battery (KAP--Kurze Aphasieprüfung). 90 of 104 consecutively recruited patients could be tested within the first three days. 53.8% (n = 49/N = 91) of the patients presented with language disorders in the clinical neurological examination at admission compared to 63.7% (n = 58/N = 91) that were found to have language disorders according to KAP. Syndrome classification in the group of aphasias showed a frequent occurrence of global aphasia, unclassified aphasia, anomic aphasia and agraphia. Speech apraxia and alexia were always accompanied by aphasia. A large amount of patients are affected by a variety of speech disorders. This study could show that a portion of these disorders could not be diagnosed in the acute situation without using a standardized test battery. Therefore clinical examination should be supplemented by standardized tests in routine diagnosis of speech disorders in acute stroke units in order to treat every patient adequately as soon as possible.