[Legal Capacity in patients with post-stroke-aphasia]

Aphasia is a frequent cognitive disorder after stroke. Despite a high prevalence, there is comparatively little medical literature or high court jurisdiction concerning the question if aphasia impairs patients in their legal capacity.Imaging studies allow a detailed understanding of the underlying pathology of aphasia, the resulting clinical pictures and potential mechanisms of recovery. Based on functional-anatomical models of language and associated concepts of inner speech, the impact of language disorders on legal capacity is evaluated. A phase model for the assessment of patients with aphasia is proposed, accounting for different stages of potential recovery after stroke.In practice, evaluation of the prerequisites for legal capacity or incapacity in patients with aphasia requires an interdisciplinary cooperation between neurologists, psychiatrists and speech language therapists. In cases of ex-post assessment, the evaluation of legal incapacity at a specific date, however, relies on a detailed documentation of the patient's language impairment and its recovery. To overcome the current limitations standardized and test-based assessment of neuropsychiatric and language capacities after acute hospital treatment and rehabilitation treatment is desirable.