Aphasia

Aphasia is a language disorder that affects how you use and understand language. With this disorder, it’s hard to express yourself, understand what others say to you, or read or write.

Typically, you develop aphasia because you have a condition that damages Broca’s area and Wernicke’s area. These are your brain’s language centers. Broca’s area is in your frontal lobe. It controls the muscles you use to speak. Wernicke’s area is in your temporal lobe. It controls your ability to understand and use the right words when you talk.

Stroke and head injuries that damage the language center of your brain are common causes. You may have aphasia if you have a condition that disrupts how your brain works. Aphasia can affect anyone. But it’s more common in people aged 65 and older. The effects of aphasia can be temporary, like during a migraine, or more long-lasting, like after a traumatic brain injury. Speech therapy may help.

Types of aphasia

There are many types of this condition, including:

• Anomic aphasia
• Broca’s aphasia
• Conduction aphasia
• Global aphasia
• Primary progressive aphasia (PPA)
• Wernicke’s aphasia (receptive aphasia)

There are types of aphasia that don’t involve your language centers. Transcortical aphasias affect areas just outside the Broca and Wernicke areas in your brain.

Symptoms of aphasia

Your symptoms will vary depending on the type of aphasia. With aphasia, it may be difficult for you to:

• Express yourself: It may be hard for you to find the right words. You may say the wrong word or make new words. You may switch letter sounds, repeat words or phrases, or use single words instead of communicating with full sentences. Healthcare providers may call this expressive aphasia.
• Understand language: The words people speak may become a jumble of sounds. You may not know how to name objects or what words mean. It can be hard to follow conversations or listen to more than one person at a time.
• Read and write: It may be challenging to understand words written on signs, computer screens or in books. You may have issues spelling words or forming sentences. Numbers may be confusing, so you can’t tell time, count money or add and subtract.

Aphasia causes

Aphasia may be a complication of conditions that damage the language centers in your brain. These may include:

• Brain infection or inflammation
• Brain tumor
• Progressive neurological diseases, like Alzheimer’s disease or dementia
• Stroke
• Traumatic brain injury

You can develop aphasia if you have a condition that keeps your brain from working as it should. That can happen if you have conditions like:

• Aneurysm
• Cerebral hypoxia
• Concussion
• Epilepsy
• Inherited disorders, like Wilson’s disease
• Migraine
• Transient ischemic attack

Aphasia may be a complication of brain surgery or cancer treatments, like chemotherapy or radiation therapy. Exposure to toxins can also cause it.

Complications of aphasia

Aphasia can affect your quality of life. Struggling to communicate may make you feel frustrated or angry. You may develop depression because you feel isolated.

How doctors diagnose aphasia

A healthcare provider will do a physical exam. They’ll ask about your symptoms and medical history. Aphasia may make it hard for you to understand and communicate. If that’s your situation, ask a family member or friend to come to the appointment with you. They may be able to share helpful information.

Your provider may do tests, including:

• Blood tests to check for conditions that may cause aphasia
• Electroencephalogram (EEG) to track your brain’s electrical signals
• Evoked potentials test to diagnose neurological conditions
• Imaging tests, like CT, MRI or PET scans

Your provider may refer you to a speech-language pathologist (SLP). This specialist may do tests to find out what type of aphasia you have. The tests may check whether you can understand language (listen), speak and hold a conversation. The tests also check your ability to express your thoughts, read and write.

How is aphasia treated?

Your healthcare provider will treat the underlying cause. For example, a stroke may cause aphasia by keeping blood from getting to your brain. Quickly restoring blood flow may limit the damage and your risk of long-term aphasia. Typically, aphasia symptoms get better as your brain heals.

Your provider may recommend speech therapy if you have long-term or permanent brain damage. This treatment 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.

Recovery time

Your recovery will depend on factors like your symptoms and what caused aphasia. In some cases, the condition goes away. But it can be a lifelong condition if there’s permanent damage to the language centers in your brain. In that case, speech therapy may make your symptoms less noticeable. Your healthcare provider is the best person to ask what you can expect.

When should I see my healthcare provider?

Talk to a healthcare provider if you or others notice language issues. If you have aphasia, tell your provider about symptoms that get worse over time.

When should I go to the emergency room?

Get medical care right away if you suddenly have aphasia symptoms. Your symptoms may mean you’re having a stroke. Call 911 or emergency services if you have stroke symptoms like:

• Weakness, numbness or paralysis on one side of your body
• Drooping on one side of your 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’s the life expectancy for someone with aphasia?

Aphasia doesn’t affect how long you’ll live. But some conditions that cause it, like stroke or a brain tumor, may be life-threatening.

What other conditions cause the same symptoms as aphasia?

Alexia, agraphia and auditory verbal agnosia are examples of conditions that cause similar symptoms:

• Alexia and agraphia: Alexia is word blindness. Agraphia is the inability to write. The conditions happen if something damages the language centers in your brain.
• Auditory verbal agnosia: In this case, your brain can’t process sensory information, like interpreting spoken language.