WHAT IS APHASIA?

Carla Hay-Perdue, DNP, APRN, FNP, ANP-BC, NC-BC

Community Education Coordinator/ Family Nurse Practitioner at Palo Pinto General Hospital

June 6, 2022

Over 2,000,000 Americans have the disorder of aphasia.  Aphasia awareness increased by the recent announcement that Bruce Willis was stepping back from acting because of aphasia. 

So, what is it? 

 Aphasia is an acquired communication disorder that impairs a person’s ability to process language. They still retain their intelligence.   It is a result of a brain injury like a stroke, head trauma, brain tumor, neurological disorders, or infection.  A stroke is the most common cause accounting for 40% of the cases.   The injury causes damage in the portions of the brain that are responsible for language.     Aphasia can be so severe that it makes communication with the patient almost impossible, or it can be very mild.  It can be as simple as impairment of the ability to retrieve the names of objects or it can affect the ability to put words together into sentences or the ability to read.   More commonly multiple aspects of communication are impaired. 

Most people who have aphasia are middle-aged or older, but anyone can acquire it.  There are 2 types of aphasia – nonfluent and fluent.  In nonfluent the damage occurs in the frontal lobe of the brain. In fluent the area of damage is in the junction of the temporal and parietal lobes of the brain.  Below is a list of the types of aphasia, their category, and the symptoms.

 

Category

Type

Symptoms

Nonfluent

Broca’s aphasia

You know what you want to say and can understand others. However, speech is difficult and requires great effort. Short phrases are often used, such as “Want food.” Some weakness or paralysis of the limbs on one side of the body may also be present.

Nonfluent

global aphasia

This is the most severe aphasia. You can’t produce and sometimes can’t understand language. However, you’ll still have normal cognitive ability in areas not related to language and communication.

Nonfluent

transcortical motor aphasia

You can understand language but can’t communicate fluently. You may use short phrases, have a delay in response time, and frequently repeat things.

Fluent

Wernicke’s aphasia

You can speak in long sentences. However, these sentences have no obvious meaning and can contain unnecessary or even made up words. Trouble with understanding language and with repeating things is also present.

Fluent

conduction aphasia

You can still speak fluently and can understand language but have trouble with repetition and finding words.

Fluent

anomic aphasia

This is a more mild aphasia. Your speech is fluent and you can understand others. However, you’ll often use vague or filler words. You may often feel like a word is on the tip of your tongue and may use other words to help describe the word you’re looking for.

Fluent

transcortical sensory aphasia

You have trouble comprehending language, although you can communicate fluently. Like Wernicke’s aphasia, your sentences may have no obvious meaning. But unlike Wernicke’s aphasia, you’re able to repeat things, although echolalia may occur in some cases.

Healthline (2022). Types of aphasia chart.  Retrieved from  Bruce Willis is Living With Aphasia. Here’s What That Means. (healthline.com)

 

 

 

Since aphasia results from a brain injury, the most important thing is to keep your brain healthy!  

  1. Protect your brain from injury by wearing a helmet during biking or contact sports.
  2. Limit alcohol consumption to 1 drink per day for females and 2 for males.
  3. Decrease your stroke risk by keeping your blood pressure and cholesterol under control, exercising regularly, getting 7-8 hours of sleep per night, following the Mediterranean diet guidelines.

See your doctor immediately if you have difficulty speaking, trouble understanding speech, difficulty with word recall, or problems with reading or writing.  Time is crucial. 

The cause of the aphasia can be diagnosed through imaging tests like an MRI or CT of the head.  These identify the areas of the brain that are damaged.  The doctor may perform a basic language skills exam in which the patient is asked to carry on a conversation, name objects answer questions and follow instructions.

Following a brain injury resulting in aphasia, it is essential to improve communication abilities as much as possible. Referring to a speech-language therapist can help do this. Rehabilitation aims to improve everyday communication to enhance the quality of life.

Some people with aphasia can recover entirely without treatment. However, most will have some residual aphasia Speech-language therapy is the mainstay treatment. The goal is to enhance the ability to communicate, aid in restoring as much of the speech and language capability as possible, and teach different communication strategies, such as through gestures, pictures, or assistive technology. The effectiveness depends on the area damaged, the damage severity, and the age and health of the person. So far, medication is ineffective in treating aphasia, but research continues.  

 

References:

 

National Aphasia Association.   (2022). Learn about aphasia. Retrieved from Home – National Aphasia Association

Mayo Clinic (2022), Aphasia.  Retrieved from Aphasia – Symptoms and causes – Mayo Clinic