Aphasia

What is aphasia?

Aphasia is a disorder that affects how you communicate and understand language. It makes it difficult to:

• Talk.
• Listen.
• Read.
• Write.

You might think about the challenges you’d face trying to communicate when traveling to another country. But what if the language you use every day suddenly becomes foreign? You might not be able to ask for a glass of water if you’re thirsty. You wouldn’t be able to understand a story that your friend is telling you. And frighteningly enough, you wouldn’t be able to tell someone that you’re hurt. For many people, this is what it might feel like to have symptoms of aphasia.

This condition happens after damage to the language center of your brain, usually after a stroke. It can also happen with conditions that disrupt how your brain works. The effects of aphasia can be temporary, like during a migraine, or more long-lasting, after a traumatic brain injury.

While aphasia affects your ability to communicate, it doesn’t affect your intelligence. Treatment options are available to help you communicate and better understand different forms of language.

What are the types of aphasia?

There are multiple types of aphasia, including:

• Anomic aphasia.
• Broca’s aphasia (expressive aphasia).
• Conduction aphasia.
• Global aphasia.
• Mixed transcortical aphasia.
• Progressive primary aphasia (PPA).
• Transcortical motor aphasia.
• Transcortical sensory aphasia.
• Wernicke’s aphasia (receptive aphasia).

How common is it?

In the United States, an estimated 180,000 people are diagnosed with aphasia each year. This equals about 1 in every 272 people.

What are the symptoms of aphasia?

The symptoms of aphasia vary based on what type you have. However, most types cause difficulty in finding, understanding and recognizing different forms of language:

• Trouble finding and using expressive language: Difficulty finding the right words, saying the wrong word, switching letter sounds, making new words, repeating common words or phrases, saying single words instead of full sentences.
• Difficulty understanding language: Not easily recognizing an object’s name or a word’s meaning, following directions, grasping the details of a conversation, listening to more than one person speak at a time, not picking up on jokes or puns.
• Challenges reading and writing: Not understanding written language (on signs, computers, books, etc.), spelling words and forming sentences, using numbers (mathematics, counting money or telling time).

What causes aphasia?

Damage to the language center of your brain (areas of your brain involved in language) causes aphasia. The most common causes of aphasia include:

• Stroke.
• Traumatic brain injury (TBI).
• Brain tumor.
• A brain infection.
• Brain inflammation.
• Progressive neurological conditions like dementia and Alzheimer’s disease.

Aphasia can happen with any condition that damages your brain. It can also happen with problems that disrupt how your brain functions. Other possible causes include:

• Aneurysms.
• Brain surgery.
• Cerebral hypoxia.
• Concussion.
• Congenital (present at birth) conditions.
• Epilepsy.
• Genetic conditions like Wilson’s disease.
• Migraines.
• Radiation therapy or chemotherapy.
• Toxins and poisons (such as carbon monoxide poisoning or heavy metal poisoning).
• Transient ischemic attacks (TIAs).

What area of the brain does it affect?

The location of the damage in your brain determines the type of aphasia you have. There are two main parts of your brain that involve language, including:

• Broca’s area: This is in your frontal lobe. It’s on the left side, in front of your temple. It controls the muscles you use to speak.
• Wernicke’s area: This is in your temporal lobe. It’s on your left side, just above your ear. It controls your ability to understand and select the right words to use when you talk.

These two areas of the brain work together to help you speak. Wernicke’s area processes your understanding of words and picks which ones you use. Then, it sends signals to Broca’s area. Once Broca’s area knows what words to use, it sends the signals to the muscles you use when you speak.

What are the risk factors for aphasia?

Aphasia can affect anyone at any age. It’s more common after age 65, especially after a stroke, event or condition that damages your brain. Aphasia can happen suddenly after these events.

What are the complications of aphasia?

Aphasia affects your ability to communicate your wants and needs. You might not be able to tell someone you’re hungry or tired, that you need help or something’s wrong. This can lead to:

• Frustration.
• Anger (possibility of violence).
• Isolation.
• Depression.

Because there’s a language barrier, caregivers may also feel frustrated and upset that they can’t effectively communicate with their loved ones.

How is aphasia diagnosed?

A healthcare provider will diagnose aphasia after a physical exam and testing. During the exam, your provider will ask you questions about your health history and symptoms. It can be difficult for you to answer these questions or understand what your provider is asking you. It helps to have a caregiver or loved one with you during your exams to help fill in the blanks if you need it.

If your provider suspects aphasia, they may refer you to a speech-language pathologist (SLP). A speech-language pathologist will offer a comprehensive exam to learn more about your ability to understand language (listen), speak and hold a conversation, express your thoughts, read and write. This helps your provider determine what type of aphasia you have.

Your provider will also evaluate the following factors to make a complete diagnosis:

• Fluency. Do you speak smoothly and easily? Does your speech have the right pace, pitch, pronunciation and grammar? Can you write without difficulty?
• Understanding. Do you understand what other people are saying? Do you say phrases and sentences that make sense? Can you read and understand written words?
• Repetition. Do you have any trouble repeating words, phrases or complete sentences?

What tests diagnose aphasia?

Your provider will recommend running several tests to diagnose aphasia or rule out conditions with similar symptoms. The tests may even determine what kind of treatments will work best.

Testing may include:

• Blood tests.
• CT (computed tomography) scan.
• Electroencephalogram (EEG).
• Electromyogram.
• Evoked potentials test.
• MRI (magnetic resonance imaging) scan.
• Positron emission tomography (PET) scan.

How is aphasia treated?

Your healthcare provider will treat the underlying cause of aphasia to manage your symptoms. For example, if you experienced a stroke, quickly restoring blood flow to the affected area of your brain can sometimes limit or prevent permanent damage. The aphasia usually gets better as you recover and your brain heals.

Some causes of aphasia don’t need treatment, since they’re temporary, like with concussions or migraines.

If you have long-term or permanent brain damage, speech therapy can improve your language abilities. Speech therapy builds or rebuilds your understanding of language and teaches you skills to adapt to specific symptoms. Speech therapy can also involve caregivers and loved ones, so they know how best to communicate with and help you.

What medications treat aphasia?

Medications may help treat the cause of aphasia. These vary widely. Your healthcare provider will recommend possible treatments specific to your situation. They’ll also consider any underlying health conditions or preferences that might impact your care.

How soon after treatment will I feel better?

The time it takes to recover from aphasia depends on what caused it, how severe it is and available treatment options. Your healthcare provider is the best person to tell you more about your recovery timeline.

Can aphasia be prevented?

Aphasia happens unpredictably, so it’s not possible to prevent it. However, you can try to reduce your risk of developing conditions that cause it. Some of the things you can do include:

• Eating balanced meals and exercising regularly. Many conditions that cause aphasia relate to your circulatory and heart health. Taking care of your overall health is a great first step.
• Not ignoring infections. Eye and ear infections need fast treatment. If these infections spread to your brain, they can become serious, or even deadly. Some infections can cause brain damage that can lead to aphasia.
• Wearing safety equipment. Head injuries can cause brain damage. Whether you’re on the job or on your own time, using safety equipment can help you avoid an injury that can lead to aphasia. Examples of safety gear include helmets and seat belts (or other vehicle safety restraints).
• Managing underlying health conditions. Managing chronic conditions can help prevent complications that can cause brain damage and aphasia.

What’s the outlook for aphasia?

In some cases, aphasia is short-term and will go away completely over time. For others, aphasia may be a lifelong condition if the language center of your brain has permanent damage. Speech therapy may improve aphasia symptoms but can’t fully reverse this condition’s effects.

The outlook for aphasia depends on several factors like your general health and what caused your symptoms. Your healthcare provider will explain more about your outlook, specifically.

How do I take care of myself?

Aphasia may make some everyday tasks more difficult, but it doesn’t have to take over your life. Here are some ways that you can take care of yourself:

• See your healthcare provider regularly.
• Follow your treatment plan.
• Seek out support groups.
• Look for alternate ways to communicate and try new technology when available.
• Carry an identification card with you at all times that tells others that you have aphasia.

Your provider can give you additional recommendations specific to your situation.

When should I see a healthcare provider?

If you gradually notice you have symptoms of aphasia, you should talk to a healthcare provider as soon as possible. You should also talk to your provider if you have aphasia symptoms that get worse over time.

When should I go to the ER?

If aphasia symptoms appear suddenly, you should get emergency medical attention. When aphasia symptoms happen quickly or without warning, it can be a sign of a stroke, for example. You should call 911 (or your local emergency services number) immediately.

You should also get help if you notice any of the symptoms of stroke (regardless of whether or not they happen along with symptoms of aphasia) in yourself or someone near you. Those symptoms include:

• Weakness, numbness or paralysis on one side of the body.
• Slurred or garbled speech.
• Droop on one side of the face or vision loss in one eye.
• Trouble swallowing.
• Confusion, irritability or agitation.
• Trouble focusing, thinking or remembering.
• Sudden headache that’s severe or keeps you from going about your usual activities.

What other conditions look like aphasia?

There are several conditions that involve or look like aphasia. But these conditions have different underlying causes and symptoms. Other conditions may include:

• Alexia (word blindness) and agraphia (inability to write): Damage to the parts of your brain that control your ability to speak can also affect your reading and writing abilities. You may see words but not be able to recognize or read them. People with agraphia lose the ability to write. These can happen at the same time, but in rare cases.
• Auditory verbal agnosia: This is a condition where you can hear people speaking but can’t recognize that what you hear is other people talking. It happens when there’s a disruption in an area of the brain that processes sound or spoken language.