Merve SAPMAZ ATALAR, Pelin ÖZCAN ULUBELİ, Suna TOKGÖZ YILMAZ

NÖROJENİK KEKEMELİĞE YAKLAŞIM

Bu çalışmada, edinilmiş nörojenik kekemeliğin epidemiyolojisi, patofizyolojisi, tanı, değerlendirme ve terapisi ile ilgili bilgileri sentezleyerek gelecekteki araştırmalara ve klinik alana katkıda bulunulması amaçlanmıştır. İncelemede geleneksel derleme metodu kullanılmış, bu kapsamda; nörojenik kekemeliğin tanımlanması, insidansı, etiyolojisi, altta yatan mekanizmalar, ayırt edici özellikleri, değerlendirme ve terapisine ilişkin literatür incelemesi gerçekleştirilmiştir. Etiyolojisine göre ayrılan nörojenik kekemelik, edinilmiş kekemeliğin alt sınıflamasında yer almaktadır. Nörojenik kekemeliğin, çeşitli nörolojik hasar veya hastalık nedeniyle ortaya çıkan edinilmiş konuşma bozukluğu olarak tanımlandığı görülmüştür. Konuşma akışını ve ritmini bozacak bir şekilde, seslerde veya hecelerde tekrarlama, uzatma veya bunların blok şeklinde üretilmesi ile karakterize edilmiştir. Nörojenik kekemeliğin yaygın nedenleri arasında inme ve travmatik beyin hasarı yer almaktadır. Nörojenik kekemeliğin patofizyolojik mekanizması tam olarak açıklanamamıştır. Bu bozukluk, diğer dil ve konuşma bozuklukları ile benzer özellikler taşır veya bir arada görülebilir. Dolayısı ile bu bozukluğa ve ayırıcı tanıya yönelik detaylı bir değerlendirme yapılması terapi planını oluşturmaya yardımcı olacaktır. Nörojenik kekemeliğin değerlendirmesinde vaka geçmişi, vakanın dil, sesletim, bilişsel ve motor becerileri, konuşmasının akıcısızlık ve diğer özellikleri ile kekemeliğine dair tutumu gibi birçok alan detaylı bir şekilde ele alınmalıdır. Terapisinde; kişiden kişiye farklı etki gösterebilecek, akıcılığı iyileştirmeye ve hıza odaklanan çeşitli dil ve konuşma terapisi stratejilerinden yararlanılmasının optimum fayda sağlayacağı düşünülmektedir.

Anahtar Kelimeler:

Edinilmiş kekemelik, nörojenik kekemelik, akıcılık bozuklukları, konuşma bozuklukları

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