Aphasia

What is aphasia?

Aphasia is a language disorder that affects how you communicate. It's caused by damage in the area of the brain that controls language expression and comprehension. Aphasia leaves a person unable to communicate effectively with others. A person with aphasia may have trouble understanding, speaking, reading, or writing.

Many people have aphasia after a stroke. Both men and women are affected equally. Aphasia can occur at any age. It is most commonly seen in those over 65 years of age.

There are many types of aphasia. These are usually diagnosed based on which area of the language-dominant side of the brain is affected. Also on the extent of the damage. For example:

• People with Broca aphasia have damage to the front part of the language-dominant side of the brain.

• People with Wernicke aphasia have damage to the side of the language-dominant part of the brain.

• People with global aphasia have damage to a large part of the brain that controls language.

What causes aphasia?

Aphasia is caused by damage to the language-dominant side of the brain, usually the left side. It may be brought on by:

• Stroke

• Head injury

• Brain tumor

• Brain infection

• Dementia or Alzheimer disease

It's currently not known if aphasia causes the complete loss of language structure, or if it causes problems in how language is accessed and used.

What are the symptoms of aphasia?

The symptoms of aphasia depend on which type a person has.

Broca aphasia is sometimes called an expressive aphasia. People with this type of aphasia may eliminate the words "and" and "the" from their language, for example. They may speak in short, but meaningful, sentences. They usually can understand some speech of others. People with Broca aphasia often have right-sided weakness or paralysis of the arm and leg.

Wernicke aphasia is sometimes called a receptive aphasia. People with this type of aphasia may speak in long confusing sentences, add unnecessary words, or create new words. They usually have trouble understanding the speech of others.

People with global aphasia have trouble with speaking or understanding language.

How is aphasia diagnosed?

Aphasia can be diagnosed using language tests done by a speech-language pathologist. These tests include studying speech, naming, repetition, comprehension, reading, and writing. Making a diagnosis may also include the use of imaging procedures to look at the brain, such as:

• CT scan. This imaging test uses X-rays and a computer to make detailed images of the body. A CT scan shows details of the bones, muscles, fat, and organs. CT scans are more detailed than general X-rays.

• MRI scan. This test uses large magnets, radio frequencies, and a computer to make detailed images of organs and structures in the body without the use of X-rays.

• Positron emission tomography. This computer-based imaging method uses radioactive substances to examine body processes.

How is aphasia treated?

Treatment will depend on your symptoms, age, and general health. It will also depend on how bad the condition is.

The goal of treatment is to improve the ability to communicate through methods that may include:

• Speech-language therapy

• Nonverbal communication therapies, such as computers or pictures

• Group therapy for patients and their families

Living with aphasia

Some people with aphasia fully recover without treatment. But for most people, some amount of aphasia typically remains. Speech therapy can often help recover some speech and language functions over time. But many people continue to have problems communicating. This can sometimes be difficult and frustrating both for the person with aphasia and for family members. It's important for family members to learn the best ways to communicate with their loved one. Speech therapists can often help with this. Suggestions might include:

• Include the person with aphasia in conversations 

• Simplify language by using short, simple sentences

• Repeat key words or write them down to clarify meaning as needed

• Use a natural conversational manner at an adult level

• Encourage all types of communication, including speech, gestures, pointing, or drawing

• Don't correct the person's speech

• Give the person plenty of time to express themselves

• Help the person become involved outside the home, such as through support groups

For some people, computers can be helpful for both communicating and improving language abilities.

Key points about aphasia

• Aphasia is a language disorder caused by damage to parts of the brain that control speech and understanding of language.

• Depending on which areas of the brain are affected, a person might have different levels of ability to speak, read, write, and understand others.

• Aphasia might get better over time, but many people are left with some loss of language skills. Speech therapy can often be helpful, as can other tools, such as computers that can help people communicate.

• Aphasia can be difficult and frustrating for both the person with aphasia and family members. It's hard but important for family members to be patient and learn the best ways to communicate with their loved one.

Next steps

Tips to help you get the most from a visit to your healthcare provider:

• Know the reason for your visit and what you want to happen.

• Before your visit, write down questions you want answered.

• Bring someone with you to help you ask questions and remember what your provider tells you.

• At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.

• Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are and when they should be reported.

• Ask if your condition can be treated in other ways.

• Know why a test or procedure is recommended and what the results could mean.

• Know what to expect if you do not take the medicine or have the test or procedure.

• If you have a follow-up appointment, write down the date, time, and purpose for that visit.

• Know how you can contact your healthcare provider if you have questions, especially after office hours or on weekends.