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). Where and how bad the brain damage is and what caused it determine the degree of disability.

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

The severity and scope of the problems depend on the extent of damage and the area of the brain affected.

Types of aphasia

Your doctor may refer to aphasia as nonfluent, fluent or global:

  • Nonfluent aphasia. Damage to the language network near the left frontal area of the brain usually results in Broca aphasia, which is also called nonfluent aphasia. People with this disorder 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.

    People with Broca aphasia may understand what other people say better than they can speak. They're often aware of their difficulty communicating and may get frustrated. People with Broca aphasia may also have right-sided paralysis or weakness.

  • Fluent aphasia. People with this form of 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. Also known as Wernicke aphasia, this type of aphasia is the result of damage to the language network in the middle left side of the brain.
  • Global aphasia. 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.

March 21, 2015
References
  1. Clark DG. Approach to the patient with aphasia. http://www.uptodate.com/home. Accessed Feb. 25, 2015.
  2. Aphasia. The Merck Manual Professional Edition. http://www.merckmanuals.com/professional/neurologic_disorders/function_and_dysfunction_of_the_cerebral_lobes/aphasia.html#v1034169. Accessed Feb. 25, 2015.
  3. Clark DG. Aphasia: Prognosis and treatment. http://www.uptodate.com/home. Accessed Feb. 25, 2015.
  4. Aphasia. American Speech-Language-Hearing Association. http://www.asha.org/public/speech/disorders/Aphasia.htm. Accessed Feb. 25, 2015.
  5. Aphasia. National Institute on Deafness and Other Communication Disorders. http://www.nidcd.nih.gov/health/voice/Pages/aphasia.aspx. Accessed Feb. 26, 2015.