What Is Aphasia?

Aphasia is a condition characterized by the sudden loss of the ability to communicate. It typically occurs suddenly after a brain injury , most commonly after a stroke, but can also happen gradually as the result of a slow-growing brain tumor or a progressive neurological disease. Transient, or temporary, aphasia can also occur as a symptom of migraine . Aphasia can affect a person’s ability to speak, write, and understand language, both written and verbal. Its severity varies from mild to making communication nearly impossible. Approximately 2 million people in the United States have aphasia, and there are nearly 180,000 new cases each year, according to the National Aphasia Association. Aphasia mostly affects adults in mid- to late life, but anyone can get it, including young children. ( 1 ) Once aphasia is diagnosed and a cause is identified, a medical professional will prescribe a treatment plan to help the person affected relearn and practice language skills and find other ways to communicate. ( 2 )
Types of Aphasia There are a number of different types of aphasia, depending on what part of the brain is affected. These include: Nonfluent aphasia This form of aphasia is also called Broca’s aphasia, in which the left frontal area of the brain is affected. Speech is severely affected in people with nonfluent aphasia, often limited to short utterances of less than four words. Vocabulary is limited and it takes great effort for those with the condition to form sounds. People with Broca’s aphasia are often able to understand speech and read well, but their writing and speaking abilities may be greatly affected. Fluent aphasia People with fluent aphasia tend to speak easily and fluently in long complex sentences, but these sentences do not make any sense, or they include unrecognizable or incorrect words. The condition, also called Wernicke’s aphasia, robs individuals of their ability to understand spoken language well, and they don’t realize that others can’t understand them. Fluent aphasia is caused by damage to the middle left side of the brain. Global aphasia This is the most severe form of aphasia, in which those affected can say only a few unrecognizable words and understand little to no spoken language. The ability to read and write is gone. People with global aphasia have extensive brain damage, usually from a stroke. Mixed nonfluent aphasia This condition resembles Broca’s aphasia, in which patients have limited speech. But unlike Broca’s aphasia, these patients also have difficulty understanding speech, as well as reading and writing. Anomic aphasia This form of aphasia occurs when people are unable to find the words for the things they want to talk or write about, particularly significant nouns and verbs. Their speech is fluent and grammatically correct, but they talk in vague expressions. They understand speech quite well and, in most cases, can read. (1,2) RELATED: Recovering From Stroke? 9 People Who Will Help You Heal
Symptoms of Aphasia Symptoms Aphasia is a sign of an underlying medical condition, such as a stroke. Symptoms of aphasia include: Speaking in short or incomplete sentences Speaking in ways that do not make any sense or saying unrecognizable words Substituting one word or sound for another Not understanding what other people are saying Writing words or sentences that do not make any sense (1)
Causes of Aphasia Causes Aphasia occurs commonly after a brain injury and most commonly after a stroke. A stroke is caused by either a blood clot (ischemic stroke) or bleeding in the brain (hemorrhagic stroke). The loss of blood to a region of the brain can lead to brain cell damage or death in the regions that control language. (1) Other, less common, causes of the condition include a brain tumor or a progressive neurological disease. Migraine can cause transient aphasia, typically during the aura phase of a migraine attack, which occurs before or overlaps with the headache phase. RELATED: Top 10 Signs You’re Heading for a Stroke How Is Aphasia Diagnosed? Aphasia is commonly first recognized by the doctor who treats a patient for a brain injury or stroke. Typically, the person will undergo a magnetic resonance imaging (MRI) or computerized tomography (CT) scan to confirm the presence of a brain injury and identify its location in the brain. Testing also includes an assessment of language skills, in which the physician may ask the patient to name common objects, engage in conversation, answer questions about something read or heard, repeat words or sentences, follow instructions, and read and write. (1, 3 )
Treatment for Aphasia Treatment In certain cases, if the damage to the brain is mild, a person may recover from aphasia without any treatment. But most people need treatment to recover language skills, in the form of speech and language therapy. This can be a slow process, and while most people make significant improvement, few will fully regain their pre-stroke (or injury) communication levels. The goal of speech and language rehabilitation for people with aphasia is to restore as much language as possible, and teach them how to compensate for lost language skills and find other ways to communicate. These other methods can include gestures, pictures, and electronic devices . RELATED: 8 Ways to Get Your Memory Back After a Stroke Therapy often takes place in groups where people with aphasia can practice their communication skills in a safe environment. Newer technologies have greatly expanded the tools available for people with aphasia. For example, “ virtual ” speech pathologists give patients access to therapy through a computer in the comfort of their own homes. Speech-generating applications on mobile devices and tablets also provide an alternative way for people with speech difficulties to communicate. ( 4 ,3) Loved ones are also encouraged to take part in patients’ therapy . Healthcare providers have the following recommendations for family members. Participate in therapy sessions when possible. Simplify language by speaking in brief, uncomplicated sentences. Avoid correcting the person’ s speech. Maintain natural conversation appropriate for an adult and include the person with aphasia in conversations. Allow the person plenty of time to talk. Encourage any type of communication, from speech to gestures to drawing. Help the person engage with people outside of the home, including support groups. (4) RELATED: 9 People Who Will Help You Recover From Stroke
Drug Therapy for Aphasia Researchers are currently exploring experimental treatments for aphasia using medication. These drugs improve blood flow to the brain, enhancing the brain’s recovery abilities and the replacement of neurotransmitters (chemicals that transmit nerve impulses) in the brain. Several drugs have shown benefits in small studies, but more research is needed before treatments can become widely available. (3)
Complications of Aphasia Complications Aphasia can greatly impact a person’s quality of life, because the inability to communicate can negatively affect one’s job, relationships, and day-to-day functioning. Because this can be so devastating, many people with aphasia also suffer from depression. According to the American Heart Association, about one-third of stroke survivors develop depression. ( 5 ) In a person with aphasia, signs of depression can include lack of energy, lack of interest in speech and language therapy, loss of appetite and subsequent weight loss, withdrawing from social contact with others, and difficulty sleeping . People with aphasia may also experience what’s called catastrophic reaction. This is when a person suddenly experiences overwhelming feelings of anger, frustration, depression, and a general feeling that they can’t cope with their current situation. Signs of such a reaction can include aggression, anxiety, yelling, and crying or laughing uncontrollably. (6)
Resources We Trust Mayo Clinic: A Mayo Clinic Expert Explains AphasiaCleveland Clinic: Primary Progressive Aphasia (PPA)National Aphasia Association: What Is Aphasia?American Stroke Association: Types of AphasiaBrain Injury Association: Demystifying Aphasia in Light of the Diagnosis of Bruce Willis

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