Wernicke's aphasia

Medical quality assurance by Dr. Albrecht Nonnenmacher, MD at August 4, 2016
StartWernicke's aphasia

Wernicke's aphasia is a condition caused by damage to the left side of the brain. Symptoms primarily include the inability to understand spoken language as well as the inability to speak or write meaningfully. While there is no cure, long-term therapy can be effective.

Contents

Definition & Facts

Carl Wernicke was a German neurologist who discovered what came to be known as Wernicke's area, a region in the left side of the brain that is responsible for language. Wernicke's aphasia is a type of language disorder in which an individual has difficulty comprehending and delivering verbal and written communication due to damage in Wernicke's area.

People with Wernicke's aphasia can speak in a normal cadence and speed (hence why it is sometimes called fluent aphasia), but the words that they say often do not make sense. Sometimes, the sentences of an individual with this condition may contain words that do not exist. Generally, the patient is unaware that what they are saying does not convey meaning.

All forms of aphasia generally occur in people 50 and older. According to the National Aphasia Association, approximately one million people have aphasia in America, and nearly 200,000 acquire the disorder each year.

Symptoms & Complaints

Those with Wernicke's aphasia tend to have trouble comprehending speech. In general, the individual with aphasia might convey the sense that they understand through non-verbal gestures, but they have trouble comprehending what was said.

The patient usually will have difficulty with speech. Often, they will use a made-up word. Other times, people with aphasia will alter an existing word by changing the first letter. This can involve altering a letter that then changes a word to become another existing word and therefore renders the meaning of a sentence incomprehensible. For example, changing the word "bike" to "like".

Some people with Wernicke's aphasia are considered to have anomia, a condition wherein they have difficulty mentally retrieving certain words when trying to form a sentence. People with Wernicke's aphasia often have very little understanding of verbal or written communication.

Causes

Wernicke's aphasia occurs as an effect of brain damage. The most common cause of Wernicke's aphasia is a stroke. A stroke is generally caused by a blood clot in the brain. Sometimes a blood vessel that bursts can cut off blood flow and oxygen to the brain (a ruptured aneurysm). Blood leaking from a vessel into the brain (brain hemorrhage) can also cause a stroke. If the stroke affects the right side of the brain, motor function is typically impaired. When it affects the left side, motor function remains but aphasia is one of the possible results. 

Other times, Wernicke's aphasia is caused by physical trauma as the result of a car accident or a gunshot wound. Alzheimer's disease is often linked to types of aphasia as are other types of neurodegenerative disorders. Brain tumors that occur or spread to the left side of the brain have also been known to cause the condition.

Diagnosis & Tests

The most difficult aspect of treating Wernicke's aphasia can be proper diagnosis. Sometimes aphasia is confused with apraxia. Apraxia is a condition involving speech and movement in which the brain is unable to send the right signals to the mouth and other parts of the body.

Often, Wernick's aphasia is discovered during treatment of some kind of major health incident, either a stroke or some kind of physical trauma. When a person has a traumatic brain injury, a doctor will order either a computed tomography (CT) scan or a magnetic resonance imaging (MRI) scan to determine the precise location of the damaged areas.

A medical professional will also give the patient basic tests to evaluate comprehension and speech. A doctor will generally check to see if the patient can answer questions, identify simple items, and hold a meaningful conversation.

Once aphasia is suspected, a speech-language pathologist will issue a battery of tests and exams to evaluate the cognitive abilities of the patient. These exams could include assessments of speech, language comprehension, reading ability, and the capacity to write.

Treatment & Therapy

Treatment for Wernicke's aphasia may take a long period of time, but there are those who can go from being severely impaired to making a nearly full recovery. Treatment involves helping the patient utilize existing language skills and recover lost language abilities as well as learn alternative means of communicating. Therapy can be one-on-one and in a group setting.

Contextual treatment approaches emphasize meaningful communicative exchanges between therapist and patient. This approach emphasizes the importance of establishing trust between the therapist and patient. Communication during such exchanges will require the therapist to use repetition and speak slowly. Sessions will revolve around topics that are relevant to the patient.

Computers can facilitate new ways of communicating for those with Wernicke's aphasia as can the use of pictures and drawing. Transcranial direct current stimulation may offer help for individuals with aphasia.

Prevention & Prophylaxis 

Utilizing proper safety equipment when partaking in activities that have a high risk for head injuries such as certain extreme sports as well as abiding by traffic safety guidelines while driving can reduce the risk of head trauma which is a cause of Wernicke's aphasia.

People who may have alcohol use disorder are advised to seek treatment in the form of psychotherapy and support groups in order to reduce the risk of alcohol-related brain damage and the incidence of falls which alcoholics are prone to and which often involve head injury.

Common causes of a stroke are preventable conditions like high blood pressure, diabetes, smoking, and obesity. High cholesterol is a possible factor but there haven't been conclusive studies on the topic. These conditions are preventable by adopting healthy lifestyle habits such as regular exercise and a healthy diet.