What causes aphasia?
Aphasia impairs a person's ability to process language and speak and understand other people. It's caused by damage to the part of the brain that regulates speech and communication. Aphasia prognosis and treatment vary widely and are based on the original injury.
Many cases are completely treatable and most people will survive aphasia. Prognosis, or the projected outcome, is largely dependent on the following factors:
- Cause of the original injury or illness
- Part of the brain that was affected
- Severity of the original injury or illness
- Age and health status
Any damage to the left half of the brain — where the language center is located — has the potential to cause aphasia. The original brain damage that caused the aphasia can range from minor to very serious, and sometimes life-threatening. The types of injuries and illnesses that cause aphasia include:
- Strokes or the complete or partial blockage of blood to the brain
- Head injuries, such as blunt force trauma or gunshot wounds
- Brain tumors
- Brain infections, such as meningitis
- Progressive neurologic disorders, such as Alzheimer’s disease or dementia
- Brain surgeries
Temporary or transient aphasia is also possible. It's typically not serious but can be a sign of an underlying health problem. Causes of temporary aphasia often include:
- Migraine headaches
- Seizures or abnormal electrical activity in the brain
- Transient ischemic attack (TIA), which refers to a temporary interruption of blood flow to an area of the brain
TIA can impair movement, memory, and speech, but only for a few minutes. Don't ignore these symptoms, though. If you suspect you have had a TIA, it's important to see your doctor right away. A TIA can greatly increase your chances of having a stroke in the future.
How common is aphasia?
Stroke is the most common cause of aphasia, so older people are most commonly affected. However, since aphasia is caused by brain damage, it can happen to anyone, even children. An estimated two million Americans have aphasia, and it affects approximately 180,000 Americans each year.
What are the symptoms of aphasia?
Aphasia symptoms are largely dependent on the location and severity of the original brain injury. Symptoms can vary from mild to severe. They can affect just one aspect of speech — such as word choice — or many aspects at once.
People with aphasia may show one, a few, or all of the following symptoms:
- Difficulty talking. You may struggle to think of the word you want, form a complete sentence, or make sense when you speak. For example, you may switch words, and say "dog" instead of "cat" or say completely made-up words.
- Difficulty understanding. You may not be able to understand what someone else is saying, especially if they're talking quickly or in a noisy room. Understanding jokes can be particularly difficult.
- Difficulty reading and writing. You may struggle to spell or write sentences, read words, and sometimes do math. For example, you may struggle to count money or tell time.
Depending on the original injury, and how much of the brain was damaged, a person may experience other symptoms and conditions along with aphasia. For example, a person with damage to the side of the left hemisphere of the brain may also have vision problems. A person with damage to the front of the left hemisphere may be weak or paralyzed on the right side of their body. This is because the left half of the brain controls the right side of the body.
How is aphasia diagnosed?
If a doctor suspects a person’s injuries or symptoms could be a result of aphasia, they will likely perform several tests to determine cause, prognosis, and potential treatments. These include:
- Routine screening blood tests and X-rays
- Detailed imaging of the brain, usually with a CT or MRI
- Interviews with doctors and speech-language therapists to determine memory, reading, writing, speech, repetition, and other communication and cognitive skills
- Sometimes more detailed function tests, such as hearing or genetic tests, may follow
How is aphasia treated?
The treatment of aphasia begins with treating the original brain injury or illness if possible. Many people will fully recover from aphasia soon after, even without additional treatment. Most people will experience at least some partial improvement.
Recovering from aphasia can be long and difficult for some people, but a qualified speech-language therapist can help. The goals of treatment include:
- Preserving what speaking skills the person still has
- Regaining skills that were lost
- Learning new communication strategies, usually with gestures, pictures, and electronic communication devices
After more serious injuries, treatment of aphasia can last months to years, sometimes a lifetime. But in general, if aphasia symptoms last longer than two to three months after the initial brain injury, complete return to full function is not likely. Still, many patients continue to make improvements for months, years, or even decades after the original injury.
How can family and friends help a loved one with aphasia?
During recovery, the support of loved ones can be crucial. There are many things family and friends can do to help with recovery:
- Be patient and remember intelligence is not affected
- Speak slowly and loudly
- Write things down or point to pictures
- Repeat things back
- Use simple words
- Include the person in conversations but give them time to respond
- Go to therapy sessions when appropriate
Even if recovery is slow, there's always hope. With the support of medical providers, speech-language therapists, family, and friends, people with aphasia can often have long, fulfilling lives.
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American Speech-Language-Hearing Association: “Aphasia."
Johns Hopkins Medicine: “Aphasia."
MedLink Neurology: "Aphasic Seizures".
Medscape: "Transient Ischemic Attack", "Aphasia".
National Aphasia Association: “Aphasia Definitions."
National Institute on Deafness and Other Communication Disorders: "Aphasia."
NursingAnswers.net: "Broca's Aphasia and Treatment Options for Word Finding Difficulties."
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