Aphasia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at January 22, 2016
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A minimum of one million people within the United States struggle with the language disorder known as aphasia. Aphasia is a condition that inhibits effective communication, due to impairment of language centers in the brain. Treatment is most often successful, but it is also highly dependent on the nature of a particular case.

Contents

Definition & Facts

Aphasia is a communication disorder that greatly reduces a person’s ability to convey their thoughts through speech and writing. The patient may struggle with listening, writing, speaking, and reading, and they experience trouble interpreting the words of others.

This condition occurs as a result of damage sustained in areas of the brain associated with language. The severity of aphasia is reliant upon which areas of the brain have been damaged and in what manner. Intelligence itself, however, is not impacted by this condition.

Symptoms & Complaints

A person suffering from aphasia experiences difficulties formulating language, comprehending language, and communicating through writing. These difficulties can manifest themselves in mismatched syllables, incorrectly substituted words, the usage of “gibberish,” omission of words, incomplete sentences, and sentences that do not make sense to the listener.

Conversely, they may also experience challenges in understanding information when spoken to, particularly when the speaker has a fast pace or when the environment around them is noisy.

Patients suffering from aphasia may also experience difficulty swallowing, as well as dysarthria (muscle weakness) and apraxia (a motor speech disorder). Professionals categorize cases of aphasia based on severity of symptoms. Generally, these categories include fluent aphasia, non-fluent aphasia, and global aphasia.

  • Fluent aphasia: the patient has little trouble using their voice, but the words they string together are not intelligible; typically, they do not understand others well, and they are not aware when others have difficulty understanding their speech patterns. Fluent aphasia is a result of damage to the middle left lobe of the brain.
  • Non-fluent aphasia: language is short, often with words omitted, but it can usually be understood by the listener. This category involves damage to the left frontal lobe of the brain, or the Broca’s area, for which it can be alternatively named. In this case, the patient typically understands when others are struggling to understand them.
  • Global aphasia: due to wide-spread damage in the language centers within the brain, communication is very limited; this is the most severe degree of aphasia.

Causes

Aphasia is a symptomatic condition, indicative of initial malfunction in language-related spheres of the brain. The most common cause is a stroke, which occurs when blood supply to the brain has been compromised. When blood flow, even temporarily, is restricted from the brain, this results in rapid cell death. Cell death in the brain, in turn, leads to impaired capabilities throughout the body, the nature of which depends on which brain structures have sustained the most severe damage.

Temporary episodes of aphasia have been known to be caused by seizures or extreme migraines; these are the most likely to recover without extensive medical intervention. Additionally, symptoms can occur as a result of traumatic brain injury, developing brain tumors, and progressive neurological disorders. Aphasia is directly related to impairments in language centers of the brain, whether damage has occurred suddenly or gradually.

Diagnosis & Tests

A professional healthcare provider is able to determine the severity of the condition through a number of comprehensive tests designed to evaluate the patient’s communicative capabilities. These tests can be as simple as identifying objects, carrying a conversation, answering open-ended questions, using gestures, following basic instructions, writing, and demonstrating reading comprehension.

Further testing may involve MRIs in order to determine which areas of the brain have been damaged. A specialist is then able to determine the severity and nature of a patient’s condition.

Because aphasia is predominantly triggered by extreme injury or other medical emergencies, these tests are most likely to take place in an emergency room. For follow-up appointments, it is best for the patient to bring a companion, in case the communication barrier obstructs progress.

Treatment & Therapy

Recovery most usually requires the expertise of a speech-language pathologist. Speech therapy targets language skills that have been diminished by aphasia and strives to strengthen those skills through strategic, focused activities. Language therapy is found to be most effective when initiated soon after the trauma has occurred, and the majority of patients benefit a great deal from this treatment option. A select few who suffer mild or temporary aphasia may be able to recover with time alone, but some degree of therapy is needed in almost all cases.

Some professionals even suggest vocational therapy, which helps patients assimilate back into the work and school spheres of their lives. Support groups are available for loved ones of the patient, wherein they can learn how best to communicate.

Further, researchers have begun developing medications that may expedite the recovery process. These drugs would work by stimulating blood flow to the brain and replenishing depleted neurotransmitters. Memantine and piracetam are two medications that have yielded positive results. However, more thorough research will be needed before any such drug can be confidently prescribed to aphasia patients. Currently, there is no definitive "cure" for aphasia, and recovery can be a life-long journey for some cases.

Prevention & Prophylaxis

The most effective method for preventing aphasia is to maintain a healthy, quality lifestyle and exercise proper safety precautions that reduce risk of head injury. Since stroke is the leading cause of aphasia, it is advisable to lessen the likelihood that one should occur. Preventative measures of stroke include not smoking, avoiding high blood pressure, regular exercise, maintaining a healthy weight, and redesigning dietary habits in a way that improves cardiovascular health.

To prevent head injury, risky behaviors should be avoided, and a helmet should always be worn in appropriate situations, such as skateboarding and motorcycle riding. Progressive neurological disorders, if preexisting, should be frequently evaluated by a doctor.

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