What causes aphasia? 15 possible conditions
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Aphasia is a communication disorder that affects the brain’s ability to use and understand language. Aphasia can interfere with your use of verbal and/or written communication. Aphasia can also cause problems with your ability to read, write, speak, and/or listen.
About one million Americans have some form of aphasia (National Aphasia Association).
There are three major types of aphasia: fluent, nonfluent, and global.
Patients with fluent aphasia, also called Wernicke’s aphasia, typically:
- have damage to the middle left side of the brain
- are unable to understand and use language correctly
- tend to speak in long, complex sentences
- tend to use incorrect or nonsense words
- are unable to realize that others don’t understand them
Patients with nonfluent aphasia, also called Broca’s aphasia, typically:
- have damage to the left frontal area of the brain
- speak in short, incomplete sentences
- are able to speak basic messages, though missing some words
- have a limited ability to understand what others say
- experience frustration because they realize they can’t be understood
- have weakness or paralysis on the right side of the body
Patients with global aphasia typically:
- have major damage to the front and back of the left side of the brain
- have severe problems using words
- have severe problems understanding words
- have limited ability to use a few words together
Aphasia is caused by damage to one or more areas of the brain that control language. When damage occurs, the blood supply to these areas can be interrupted. Without oxygen and nutrients from the blood supply, the cells in these parts of the brain die.
Aphasia can be caused by a brain tumor, an infection, dementia, a neurological disorder, or a degenerative disease. It can also occur suddenly from a head injury or a stroke. Strokes are the most common cause of aphasia (National Aphasia Association).
Seizures or migraines can cause temporary aphasia. Temporary aphasia can also be caused by a transient ischemic attack (TIA), which temporarily interrupts blood flow to the brain. It can also be triggered by a mini-stroke.
Aphasia affects people of all ages, including children. Since strokes are the most common cause of aphasia, the majority of people with this condition are middle-aged or older. The condition occurs in 25 to 40 percent of stroke survivors (National Aphasia Association).
Symptoms of aphasia vary from mild to severe. The effects of aphasia depend on the areas of the brain that are damaged and the severity of that damage.
Aphasia affects both spoken and written communication. It can hinder speaking, comprehension, reading, and writing. It can affect both expressive and receptive communication.
Expressive symptoms are problems using words and sentences. These symptoms can include:
- speaking in short, incomplete sentences or phrases
- speaking in sentences that can’t be understood
- using wrong words or nonsense words
- using words in the wrong order
Receptive symptoms are problems understanding the words of others. These symptoms can include:
- difficulty understanding other people’s speech
- difficulty following fast-paced speech
- misunderstanding figurative speech
If a physician suspects that a patient has aphasia, imaging tests can help find the source of the problems. A computerized tomography (CT) scan or magnetic resonance imaging (MRI) can help identify the location and severity of brain damage.
A physician may screen for aphasia during treatment for a brain injury or stroke. This may test a patient’s ability to:
- follow commands
- name objects
- participate in conversation
- answer questions
In cases of aphasia, a speech-language pathologist can identify specific communication disabilities. An examination will test the patient’s ability to:
- speak clearly
- understand verbal and written language
- express ideas coherently
- interact socially with others
- read and write
- use alternative forms of communication
Treatment for aphasia involves speech-language therapy. Typically, therapy proceeds slowly and gradually. It should start as early as possible after a brain injury. A treatment plan can include:
- exercises to improve and practice skills
- learning to use other forms of communication, such as gestures, drawings, and computers
- working in groups to practice communication skills
- testing skills in real-life situations
- using computers for relearning word sounds and verbs
- encouraging family involvement so patients can communicate at home
Patients with temporary aphasia caused by a TIA or migraine may not need treatment to recover completely. Most patients with aphasia recover some language abilities up to a month after a brain injury. However, a return to full communication ability is not typical.
Several factors can determine how much improvement is possible. The cause, location, and severity of brain damage affect the chance for recovery. The patient’s age and health also can be factors. Other considerations such as a patient’s motivation can impact the prognosis.
Aphasia is caused by many conditions that can’t be prevented, such as brain tumors or degenerative diseases. But the most common cause of aphasia is a stroke. By reducing your risk of stroke, you can lower your risk of developing aphasia.
The National Stroke Association recommends the following precautions to reduce the risk of stroke (National Stroke Association):
- control your blood pressure
- manage atrial fibrillation (AF), which can cause blood to form clots
- stop smoking
- drink in moderation
- control your cholesterol
- control your diabetes
- exercise daily
- eat a diet that is low in sodium and fat
- control circulation problems
- get immediate help if you have any symptoms of a stroke
- Aphasia. (n.d.). American Speech-Language-Hearing Association. Retrieved August 11, 2013, from http://www.asha.org/public/speech/disorders/Aphasia/
- Aphasia. (2012, May 8). Mayo Clinic. Retrieved August 11, 2013, from http://www.mayoclinic.com/health/aphasia/DS00685
- Aphasia Frequently Asked Questions. (n.d.). National Aphasia Association. Retrieved August 15, 2013, from http://www.aphasia.org/Aphasia%20Facts/aphasia_faq.html
- Aphasia. (2008, October). National Institute on Deafness and Other Communication Disorders (NIDCD). Retrieved August 11, 2013, from http://www.nidcd.nih.gov/health/voice/Pages/aphasia.aspx
- Types of Aphasia. (2013, May 30). National Stroke Association. Retrieved August 15, 2013, from http://www.strokeassociation.org/STROKEORG/LifeAfterStroke/RegainingIndependence/CommunicationChallenges/Types-of-Aphasia_UCM_310096_Article.jsp
- Reducing Risk and Recognizing Symptoms. (2009, August). National Stroke Association. Retrieved August 15, 2013, from http://www.stroke.org/site/DocServer/ReducingRisk_8-09.pdf?docID=3027
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