Some conditions, including stroke or head injury, can seriously affect a person's ability to communicate. Learn about this communication disorder and its care.
Aphasia is a disorder that affects how you communicate. It can impact your speech, as well as the way you write and understand both spoken and written language.
Aphasia usually happens 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 things, including the cause and the extent of the brain damage.
The main treatment for aphasia involves treating the condition that causes it, as well as 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.
Aphasia is a symptom of some other condition, such as a stroke or a brain tumor.
A person with aphasia may:
People with aphasia may have different strengths and weaknesses in their speech patterns. Sometimes these patterns are labeled as different types of aphasia, including:
These patterns describe how well the person can understand what others say. They also describe how easy it is for the person to speak or to correctly repeat what someone else says.
Aphasia may develop slowly over time. When that happens, the aphasia may be labeled with one of these names:
Many people with aphasia have patterns of speech difficulty that don't match these types. It may help to consider that each person with aphasia has unique symptoms, strengths and weaknesses rather than trying to label a particular type of aphasia.
Because aphasia is often a sign of a serious problem, such as a stroke, seek emergency medical care if you or a loved one suddenly develop:
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.
Aphasia can create numerous quality-of-life problems because communication is so much a part of your life. Communication difficulty may affect your:
Difficulty expressing wants and needs can result in embarrassment, frustration, isolation and depression. Other problems may occur together, such as more difficulty moving around and problems with memory and thinking.
Your health care provider will likely give you physical and neurological exams, test your strength, feeling and reflexes, and listen to your heart and the vessels in your neck. An imaging test, usually an MRI or CT scan, can be used to quickly identify what's causing the aphasia.
A speech-language pathologist can complete a comprehensive language assessment to confirm the presence of aphasia and determine the appropriate course of language treatment. The assessment helps find out whether the person can:
If the brain damage is mild, it's possible to recover language skills without treatment. However, most people undergo speech and language therapy to rehabilitate their language skills and supplement their communication experiences. Researchers are investigating the use of medications, alone or in combination with speech therapy, to help people with aphasia.
Recovery of language skills is usually a slow process. Although most people make significant progress, few people regain full pre-injury communication levels.
Speech and language therapy aims to improve the ability to communicate. The therapy helps by restoring as much language as possible, teaching how to make up for lost language skills and finding other methods of communicating.
Certain drugs are being studied for the treatment of aphasia. These include drugs that may improve blood flow to the brain, enhance the brain's recovery ability or help replace depleted chemicals in the brain (neurotransmitters). Several medications, such as memantine (Namenda), donepezil (Aricept, Adlarity), galantamine (Razadyne ER) and piracetam, have shown promise in small studies. But more research is needed before these treatments can be recommended.
Brain stimulation is being studied for aphasia treatment and may help improve the ability to name things. But no long-term research has been done yet. One treatment is called transcranial magnetic stimulation and another is transcranial direct current stimulation.
These treatments aim to stimulate damaged brain cells. Both are noninvasive. One uses magnetic fields and the other uses a low current through electrodes placed on the head.
If you have aphasia, the following tips may help you communicate with others:
Family members and friends can use the following tips when communicating with a person with aphasia:
Local chapters of organizations such as the National Aphasia Association, the American Stroke Association, the American Heart Association and some medical centers may offer support groups for people with aphasia and others affected by the disorder. These groups provide people with a sense of community and a place to air frustrations and learn coping strategies. Ask your health care provider or speech-language pathologist about local support groups.
If your aphasia is due to a stroke or head injury, you'll probably first be seen in an emergency room.. You'll then see a doctor who specializes in disorders of the nervous system (neurologist), and you may eventually be referred to a speech-language pathologist for rehabilitation.
Because this condition generally arises as an emergency, you won't have time to prepare. If possible, bring the medications or supplements you take with you to the hospital so that your health care team is aware of them.
When you have follow-up appointments, you'll likely need someone to take you there. In addition, this person may be able to help you communicate with your health care provider.
Some questions a loved one or friend may want to ask your provider include:
Your health care provider will likely have questions, too. A loved one or friend can help your provider get the information needed. Your provider may ask: