Paragrammatism: symptoms, causes and treatment

Language is a tool that we use daily to communicate … But what happens when it is changed? Are we aware of what this means? If we have a brain injury, a stroke, a traumatic brain injury, an infectious disease of the brain … we can develop a certain type of aphasia.

In aphasias we find Broca’s aphasia, which is characterized mainly by the fact that spontaneous language is impaired (not fluently). In addition, also this implies another great symptom: paragrammatism. In this article, we will know exactly what it is, its symptoms, causes and possible treatments.

    Paragrammatism: what is it?

    Paragramatism, also called asyntax or telegraphic language, consists of an alteration of verbal expression (I.e. spoken language), which usually manifests in motor aphasias (also known as Broca’s aphasias).

    Its main symptom is the appearance, in the speaker’s speech, of syntactically disorganized sentences, associated with the use of incorrect grammatical forms when structuring sentences.

    Thus, it implies the appearance, in the speech, of grammatical errors, and the use of an incorrect time mark in the verbs. People with paragrammatism also use pronouns inappropriately. All of these errors occur in the context of a wide variety of grammatical constructs.

    In severe cases of paragrammatism, the patient’s speech becomes completely intelligible. So, in these cases, jargaphasia also appears, which is a language disorder in which the person replaces the appropriate words with unintelligible terms.

    Pierce aphasia

    As we have seen, paragrammatism appears in Broca’s aphasia. Broca’s aphasia implies, at the cerebral level, that the third frontal convolution is injured (I.e. Brodmann zones 44 and 45). The main symptoms of this type of aphasia, beyond paragrammatism, are:

    • A spontaneous non-fluent language
    • The changed name
    • An understanding preserved
    • Altered repetition


    For this alteration to be better understood, some examples of phrases from people with paragramatism are: “I have great confidence in you” or “Thursday fails we are going to eat at six friends”.


    The main symptoms of paragrammatism are as follows.

    1. Errors in the order and sequence of words

    The first symptom of paragrammatism is a sequence of errors that appear when ordering words and sequences, at the syntactic and / or morphological level.

    Thus, people with paragrammatism tend to replace the order of sentences with a set of sentences, which at first glance may seem well structured, but in reality are not, because there is no coordination or coordination. logical connection between them.

    2. Excessively long statements

    Another symptom of paragrammatism is an exaggerated length of statements. In fact, this length is linked to two other alterations: slang (already discussed) and verbena. In this case, verbiage involves the excessive use of words when speaking, which can be a real impairment of the flow of the language, quantitatively.

    In addition, verbiage is accompanied by other symptoms, such as prolixity of speech, its acceleration, and difficulty being interrupted.

    On the other hand, in the same statement issued by the person, several changes may appear in the communicative thread, which makes their language incomprehensible.

    3. Substitution of a few words

    Another symptom is the substitution of certain types of words for others; it happens with functional words or inflectional affixes. So these they are replaced by other words belonging to the same semantic field.

    Neologisms can also appear, with similarities to the functional word it replaces. For their part, neologisms are “invented words”, as well as newly created expressions, within a language.

    4. Difficulties adapting sentences

    Another symptom of this language disorder, which is also common, is great difficulty in adapting the different sentences to the existing context.

      the causes

      The main cause of paragramatism is Drill’s aphasia, one of the existing types of aphasia. Aphasias are the loss of language function, and they come from an organic brain injury.

      There are several types of aphasia. In turn, the causes of aphasia can be multiple. Some of the most common are:

      1.cranioencephalic trauma (TCE)

      One of the possible causes of aphasia, which in turn causes paragrammatism, is traumatic brain injury (TBI).

      A TCE consists of an injury often caused by a blow to the head, Which involves an alteration of the brain; if this assignment covers the areas in charge of the tongue, aphasia occurs.

      2. Brain tumor

      Brain tumors can also cause aphasia, if they press on the area or areas of the brain in charge of the tongue.

      Tumors can be primary (if they originate in brain tissue itself) or produced by metastasis (that is, when a malignant tumor has spread to another side of the body).

      3. Accident with features of cerebrovascular O (ACL)

      These occur when the blood supply to the brain is interrupted (or when it decreases), which means that the brain cannot oxygenate itself for a few seconds. What often happens is that certain groups of neurons die.

      ACV they can be hemorrhagic or ischemic. It is estimated that about 40% of people who have had a stroke or stroke have aphasia.

      4. Infectious diseases

      Infectious diseases can also cause aphasia, although these are usually temporary aphasias, because when the infection goes away, so does the aphasia. Examples of this type of disease are: encephalitis, meningitis or brain abscesses.

      5. Degenerative diseases

      Finally, degenerative diseases can also lead to aphasia and this, in turn, to paragrammatism. Examples of this type of disease are: Alzheimer’s, Pick … Aging is generally the cause of this type of disease.


      Treatment of paragramatism involves treating aphasia as the big picture. mostly he is chosen to perform neuro-rehabilitation treatment; that is, cognitive rehabilitation, which involves a series of exercises, activities and tasks to work on language and communication.

      On the other hand also speech therapy is used to work on the affected areas by aphasia, and in the case which concerns us, the alterations derived from paragramatism.

      Thus, exercises are used which make it possible, for example, to work on sequences of sentences at the morphological and syntactic level, which requires ordering the sentences, filling in the gaps that are missing, discriminating between sounds, etc.

      Logically, each treatment will be personalized according to the type of patient and the injury.

      Bibliographical references:

      • Alexander MP (1997). Aphasia: clinical and anatomical aspects. In: Feinberg TE and Farah MJ Eds. Behavioral neurology and neuropsychology. Mc Graw Hill, New York; 133-149.
      • Belloch, A., Sandín, B. and Ramos, F. (2010). Manual of psychopathology. Volumes I and II. Madrid: McGraw-Hill.
      • Borregón Sanz, S. and González Calvo, A. (2000). Aphasia. Exploration, diagnosis and treatment. Madrid: CEPE. (2nd edition).
      • Pérez-Pàmies, M., Manero, R. Mª and Bertran-Serra, I. (2001). Aphasias. In Peña Casanova, J. Handbook of Speech Therapy. Barcelona: Masson. (Pages 369 to 407).

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