Wernicke's Aphasia (Receptive Aphasia)

What is Wernicke’s aphasia?

Wernicke’s aphasia (receptive aphasia) is a language disorder that affects your ability to make sense when speaking. It also affects your ability to understand what others are saying. Although speaking may seem easy, what you say can be confusing to others.

You might experience “word salad,” which happens when the words you use aren’t the right ones for a sentence or when you make up new words as you go. This is similar to putting a bunch of random words from a dictionary into a bowl and mixing them up. An example of a word salad is: “The green dog jump helicopter cheese on the yesterday smoodle.”

This type of aphasia doesn’t affect your intelligence. It only affects how your brain processes language.

You may hear your healthcare provider refer to Wernicke’s aphasia as fluent aphasia.

How common is Wernicke’s aphasia?

Wernicke’s aphasia is one of the most common types of aphasia that happens after a stroke.

What are the symptoms of Wernicke’s aphasia?

The symptoms of Wernicke’s aphasia (receptive aphasia) include:

• Fluent, nonsensical speech: You don’t have any trouble with the physical act of speaking. However, what you say is confusing or doesn’t make sense. You may use the wrong words or make up words.
• Problems with understanding: It’s difficult to understand what others are saying.
• Difficulty with repetition and naming: You may have trouble repeating words or phrases you say to someone else or finding the right word to identify an object.
• Reading, writing and numerical challenges: Tasks like reading, writing sentences and using numbers (mathematics) are difficult to do. You might be able to fluently write, with the correct grammar, but you spell words incorrectly or use the wrong words.
• Vision changes: The Wernicke’s area of your brain is near parts that affect your vision. You may experience partial or full vision loss in addition to communication challenges.

People with Wernicke’s aphasia often have anosognosia (an-oh-sog-no-zh-uh). This is a condition where your brain can’t recognize or process signs of a medical problem you have. That means you likely won’t know or can’t understand that you have this kind of aphasia.

What does Wernicke’s aphasia sound like?

If you have Wernicke’s aphasia, the tone and speed of your speech are as expected, but the things you say aren’t. Others might not understand what you’re saying because of word or phrase substitutions (paraphrastic errors). There are two types:

• Semantic paraphasia errors: You switch one word in a sentence for another related word. For example, you mean to say “chair,” but you say “table.”
• Phonemic paraphrastic errors: You switch a letter sound or syllable with another. For example, you mean to say “cat,” but you say “hat.”

Often, you might find it easier to replace specific words or phrases with general terms like “stuff” or “things.”

What causes Wernicke’s aphasia?

Damage to the Wernicke’s area of your brain causes Wernicke’s aphasia (receptive aphasia). The Wernicke’s area may be on the right or left side of your brain, above your ear in your temporal lobe. The most common cause of damage to this area of your brain is a stroke.

Other causes may include:

• Traumatic brain injury (TBI).
• Brain tumors.
• Central nervous system infections.
• Degenerative brain conditions like Alzheimer’s disease and Lewy body dementia.

What are the complications of Wernicke’s aphasia?

Wernicke’s aphasia makes it difficult to understand what someone’s saying and be understood by others. This can lead to:

• Confusion.
• Frustration.
• Isolation.
• Depression.

How is Wernicke’s aphasia diagnosed?

A healthcare provider will diagnose Wernicke’s aphasia after a physical exam, language evaluation and testing. Your provider will review your medical history during the physical exam.

During the evaluation, your provider will examine how your brain processes language. They’ll ask you questions and give you instructions to follow that may include:

• Simple and complex commands: Raise your hand. Touch your left ear with your right hand.
• Verbal fluency: Tell me about the weather today.
• Naming objects: Name all of the animals that you can think of. What is an object that you write with that holds ink?
• Repeating phrases: Repeat the following sentence, “The dog barked at the orange cat.”
• Reading and writing: Can you write down the following sentence? Can you read [this sentence] out loud?

A speech-language pathologist (SLP) usually performs this language evaluation and helps your care team make an aphasia diagnosis.

Imaging tests can confirm damage to the Wernicke’s area of your brain. Your provider may order one of the following tests:

• An MRI (magnetic resonance imaging).
• A CT scan (computed tomography scan).
• A PET scan (positron emission tomography scan).

It’s important to note that making a diagnosis can be challenging because you may not realize you have a problem communicating.

How is Wernicke’s aphasia treated?

There isn’t a cure for Wernicke’s aphasia (receptive aphasia). However, options are available to treat the underlying cause and help you effectively communicate and rebuild language skills.

The primary treatment option is speech therapy. During speech therapy, you’ll learn how to:

• Improve communication skills.
• Rebuild lost language function.
• Use alternative communication methods.

Many people find group therapy helpful to decrease feelings of isolation and to practice their newly learned skills with others.

Your healthcare providers can also offer support to your caregivers and loved ones so you can effectively communicate with those closest to you.

Can Wernicke’s aphasia be prevented?

There isn’t a way to prevent Wernicke’s aphasia. You can take steps to improve your general health to prevent causes of aphasia, like stroke and injury, by:

• Managing any underlying conditions.
• Eating nutritious, balanced meals.
• Participating in physical activities or exercising regularly.
• Wearing protective equipment when necessary (like a helmet during contact sports, for example).

Your healthcare provider can give you more specific tips to better your health based on your situation.

What’s the outlook for Wernicke’s aphasia?

Your outlook varies based on the severity of damage to the Wernicke area of your brain. You may see some improvement over time. On average, your language skills improve the most within the first six months after a stroke, though some people may continue to recover at a slower pace for even months to years after that.

You may need to find alternative methods of communication, like using sign language or assistive devices and technology.

It also helps to include your caregivers and loved ones in your treatment so they can learn how to communicate with you. They may need to:

• Use short sentences in conversation.
• Ask you yes or no questions.
• Avoid pointing out errors in communication.
• Be patient and inclusive.

Your healthcare providers can offer additional advice to help you and your loved ones adapt to Wernicke’s aphasia.

When should I see a healthcare provider?

Let a healthcare provider know if you or a loved one experience symptoms of Wernicke’s aphasia, especially communicating clearly with others or understanding what someone says. If you received a Wernicke’s aphasia diagnosis and your symptoms get worse, let your provider know.

If symptoms happen suddenly, it could be a sign of a stroke. Contact 911 or your local emergency services number immediately.

What questions should I ask my healthcare provider?

Questions to consider asking your provider include:

• Do I have Wernicke’s aphasia or another type of aphasia?
• What caused my symptoms?
• How often do I need to participate in speech therapy?
• Are clinical trials available?