What is Aphasia?

Aphasia is a disorder that results from damage to portions of the brain that are responsible for language. (www.nidcd.nih.gov) This class of language disorder ranges from having difficulty remembering words to being completely unable to speak, read, or write. (en.wikipedia.org) Aphasia is an acquired disorder of language due to brain damage. Aphasia does not include (1) developmental disorders of language, often called dysphasia in the United States; (2) purely motor speech disorders, limited to articulation of speech via the oral-motor apparatus, referred to as stuttering, dysarthria, and apraxia of speech; or (3) disorders of language that are secondary to primary thought disorders, such as schizophrenia. (emedicine.medscape.com) Who has Aphasia? Anyone can acquire aphasia, including children, but most people who have aphasia are middle-aged or older. Men and women are equally affected. (www.nidcd.nih.gov) According to the National Aphasia Association, approximately 80,000 individuals acquire aphasia each year from strokes. About one million people in the United States currently have aphasia. (www.medicinenet.com) What causes Aphasia? Aphasia is caused by damage to one or more of the language areas of the brain. Many times, the cause of the brain injury is a stroke. A stroke occurs when blood is unable to reach a part of the brain. Brain cells die when they do not receive their normal supply of blood, which carries oxygen and important nutrients. Other causes of brain injury are severe blows to the head, brain tumors, brain infections, and other conditions that affect the brain. (www.nidcd.nih.gov) Aphasia usually results from lesions to the language-relevant areas of the frontal, temporal and parietal lobes of the brain, such as Broca's area, Wernicke's area, and the neural pathways between them. These areas are almost always located in the left hemisphere, and in most people this is where the ability to produce and comprehend language is found. However, in a very small number of people, language ability is found in the right hemisphere. In either case, damage to these language areas can be caused by a stroke, traumatic brain injury, or other brain injury. Aphasia may also develop slowly, as in the case of a brain tumor or progressive neurological disease, e.g., Alzheimer's or Parkinson's disease. It may also be caused by a sudden hemorrhagic event within the brain. Certain chronic neurological disorders, such as epilepsy or migraine, can also include transient aphasia as a prodromal or episodic symptom. Aphasia is also listed as a rare side effect of the fentanyl patch, an opioid used to control chronic pain. (en.wikipedia.org) What are the Types of Aphasia? There are two broad categories of aphasia: fluent and non-fluent. 1) Fluent aphasia

 

Wernicke's aphasia - Individuals with Wernicke's aphasia may speak in long sentences that have no meaning, add unnecessary words, and even create new "words" (neologisms). For example, someone with Wernicke's aphasia may say, "You know that smoodle pinkered and that I want to get him round and take care of him like you want before", meaning "The dog needs to go out so I will take him for a walk". They have poor auditory and reading comprehension, and fluent, but nonsensical, oral and written expression. Individuals with Wernicke's aphasia usually have great difficulty understanding the speech of both themselves and others and are therefore often unaware of their mistakes. (en.wikipedia.org) Transcortical sensory aphasia - Similar deficits as in Wernicke's aphasia, but repetition ability remains intact. (en.wikipedia.org) Conduction aphasia - Conduction aphasia is caused by deficits in the connections between the speech-comprehension and speech-production areas. This might be caused by damage to the arcuate fasciculus, the structure that transmits information between Wernicke's area and Broca's area. Similar symptoms, however, can be present after damage to the insula or to the auditory cortex. Auditory comprehension is near normal, and oral expression is fluent with occasional paraphasic errors. Repetition ability is poor. (en.wikipedia.org) Nominal or Anomic aphasia - Anomic aphasia is essentially a difficulty with naming. The patient may have difficulties naming certain words, linked by their grammatical type (e.g. difficulty naming verbs and not nouns) or by their semantic category

(e.g. difficulty naming words relating to photography but nothing else) or a more general naming difficulty. Patients tend to produce grammatic, yet empty, speech. Auditory comprehension tends to be preserved. (en.wikipedia.org)

2) Non-fluent aphasia

 

Broca's aphasia - Individuals with Broca's aphasia frequently speak short, meaningful phrases that are produced with great effort. Broca's aphasia is thus characterized as a nonfluent aphasia. Affected people often omit small words such as "is", "and", and "the". For example, a person with Broca's aphasia may say, "Walk dog" which could mean "I will take the dog for a walk", "You take the dog for a walk" or even "The dog walked out of the yard". Individuals with Broca's aphasia are able to understand the speech of others to varying degrees. Because of this, they are often aware of their difficulties and can become easily frustrated by their speaking problems. It is associated with right hemiparesis, meaning that there can be paralysis of the patient's right face and arm. (en.wikipedia.org) Transcortical motor aphasia - Similar deficits as Broca's aphasia, except repetition ability remains intact. Auditory comprehension is generally fine for simple conversations, but declines rapidly for more complex conversations. It is associated with right hemiparesis, meaning that there can be paralysis of the patient's right face and arm. (en.wikipedia.org) Global aphasia - Individuals with global aphasia have severe communication difficulties and will be extremely limited in their ability to speak or comprehend language. They may be totally nonverbal, and/or only use facial expressions and gestures to communicate. It is associated with right hemiparesis, meaning that there can be paralysis of the patient's right face and arm. (en.wikipedia.org) Mixed transcortical aphasia - Similar deficits as in global aphasia, but repetition ability remains intact. (en.wikipedia.org) Subcortical aphasias - Characteristics and symptoms depend upon the site and size of subcortical lesion. Possible sites of lesions include thethalamus, internal capsule, and basal ganglia. (en.wikipedia.org) What are the signs and symptoms of Aphasia? People with aphasia may experience any of the following behaviors due to an acquired brain injury, although some of these symptoms may be due to related or concomitant problems such as dysarthria or apraxia and not primarily due to aphasia. (en.wikipedia.org)

                

inability to comprehend language inability to pronounce, not due to muscle paralysis or weakness inability to speak spontaneously inability to form words inability to name objects poor enunciation excessive creation and use of personal neologisms inability to repeat a phrase persistent repetition of phrases paraphasia (substituting letters, syllables or words) agrammatism (inability to speak in a grammatically correct fashion) dysprosody (alterations in inflexion, stress, and rhythm) uncompleted sentences inability to read inability to write limited verbal output difficulty in naming

How To Communicate With A Person Who Has Aphasia Talk to the person with aphasia as an adult and not as a child. Avoid talking down to the person.

Make sure you have the person's attention before communicating. Praise all attempts to speak; make speaking a pleasant experience and provide stimulating conversation. Encourage and use all modes of communication (speech, writing, drawing, yes/no responses, choices, gestures, eye contact, facial expressions). Give them time to talk and permit a reasonable amount of time to respond. Keep your own communication simple, but adult. Simplify sentence structure and reduce your own rate of speech. Keep your voice at a normal volume level and emphasize key words. Augment speech with gesture and visual aids whenever possible. Repeat a statement when necessary. Encourage people with aphasia to be as independent as possible (www.banchanida.com)

WORKS CITED: Aphasia. Wikipedia. 29 July 2011 <http://en.wikipedia.org/wiki/Aphasia>. Aphasia. National Institute on Deafness and Other Communication Disorders. October 2008<http://www.nidcd.nih.gov/health/voice/aphasia.html> How To Communicate With A Person Who Has Aphasia. BRAIN FOODS for your SMART BRAIN <http://www.banchanida.com/brain/aphasia/010.html>