Aphasia
Overview
Aphasia is a condition that robs you of the ability to communicate. It can affect your ability to speak, write and understand language, both verbal and written.
Aphasia typically occurs suddenly after a stroke or a head injury. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). The severity of aphasia depends on a number of conditions, including the cause and the extent of the brain damage.
Once the cause has been addressed, the main treatment for aphasia is speech and language therapy. The person with aphasia relearns and practices language skills and learns to use other ways to communicate. Family members often participate in the process, helping the person communicate.
Symptoms
Aphasia is a sign of some other condition, such as a stroke or a brain tumor.
A person with aphasia may:
- Speak in short or incomplete sentences
- Speak in sentences that don't make sense
- Substitute one word for another or one sound for another
- Speak unrecognizable words
- Not understand other people's conversation
- Write sentences that don't make sense
Patterns of aphasia
People with aphasia may have different patterns of strengths and weaknesses.
Expressive aphasia. This is also called Broca's or nonfluent aphasia. People with this pattern of aphasia may understand what other people say better than they can speak. People with this pattern of aphasia struggle to get words out, speak in very short sentences and omit words. A person might say, "Want food" or "Walk park today."
A listener can usually understand the meaning, but people with this aphasia pattern are often aware of their difficulty communicating and may get frustrated. They may also have right-sided paralysis or weakness.
- Comprehensive aphasia. People with this pattern of aphasia (also called fluent or Wernicke's aphasia) may speak easily and fluently in long, complex sentences that don't make sense or include unrecognizable, incorrect or unnecessary words. They usually don't understand spoken language well and often don't realize that others can't understand them.
- Global aphasia. This aphasia pattern is characterized by poor comprehension and difficulty forming words and sentences. Global aphasia results from extensive damage to the brain's language networks. People with global aphasia have severe disabilities with expression and comprehension.
When to see a doctor
Because aphasia is often a sign of a serious problem, such as a stroke, seek emergency medical care if you suddenly develop:
- Difficulty speaking
- Trouble understanding speech
- Difficulty with word recall
- Problems with reading or writing
Causes
The most common cause of aphasia is brain damage resulting from a stroke — the blockage or rupture of a blood vessel in the brain. Loss of blood to the brain leads to brain cell death or damage in areas that control language.
Brain damage caused by a severe head injury, a tumor, an infection or a degenerative process also can cause aphasia. In these cases, the aphasia usually occurs with other types of cognitive problems, such as memory problems or confusion.
Primary progressive aphasia is the term used for language difficulty that develops gradually. This is due to the gradual degeneration of brain cells located in the language networks. Sometimes this type of aphasia will progress to a more generalized dementia.
Sometimes temporary episodes of aphasia can occur. These can be due to migraines, seizures or a transient ischemic attack (TIA). A TIA occurs when blood flow is temporarily blocked to an area of the brain. People who've had a TIA are at an increased risk of having a stroke in the near future.
Complications
Aphasia can create numerous quality-of-life problems because communication is so much a part of your life. Communication difficulty may affect your:
- Job
- Relationships
- Day-to-day function
Language barriers may lead to embarrassment, depression and relationship problems.