Aphasia: Symptoms, Types, Causes & Treatment

Updated in February 2024

Aphasia is a disorder in which a person has difficulties in understanding and communicating. This condition can be diagnosed in childhood or adulthood. This condition can be caused by brain damage from a stroke, brain tumor, infections or a blow to the head.

Aphasia can be classified into two main types: Wernicke's aphasia, in which the person has difficulty understanding what other people are saying, and Broca's aphasia, in which there is a change in speech expression. The type of aphasia depends on the affected area and the severity of the signs and symptoms.

Treatment for aphasia depends on its cause. Brain tumors, for example, may need to be surgically removed, while strokes may require medication. Rehabilitation with a speech therapist is essential to recover oral and written comprehension and expression skills.

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Main symptoms

The main symptoms of aphasia are:

  • Difficulty expressing oneself, whether through oral or written language
  • Difficulty starting a sentence
  • Speaks slowly or slower than usual
  • Say sentences with few words
  • Difficulty articulating words
  • Difficult understanding oral or written orders

A decreased ability to speak and understand language may be temporary, depending on the underlying cause of the aphasia. Therefore, it is important to consult a neurologist when symptoms suggestive of aphasia appear, so that a diagnosis can be confirmed and the most appropriate treatment can be initiated.

Confirming a diagnosis

A diagnosis for aphasia is confirmed with an in-person assessment and medical examinations. Initially, the neurologist carries out a clinical assessment of the person's language. Some evaluations techniques include asking the patient to count from 1 to 10, repeat simple sentences, name objects, follow simple oral and written instructions, such as touching the tip of their nose or writing their own name.

Additionally, your doctor may order imaging tests, such as an MRI or a CT scan, to locate the affected area of the brain and determine the cause and severity of aphasia.

Types of aphasia

Aphasia is classified into several types depending on which areas of the brain are affected. Different areas will lead to different symptoms. The main types of aphasia are:

1. Wernicke's aphasia

Wernicke's aphasia is the most common type of aphasia. It can occur due to a change in the temporal lobe of the brain, compromising the area responsible for understanding speech. It is associated with difficulty in maintaining a conversation, as speech becomes incoherent.

This type is also characterized by a difficulty in understanding both oral and written language. The person cannot understand what the other person says, which can be made more difficult when the environment is noisy or another person speaks quickly. Patients with Wernicke's aphasia will also have challenges when reading a book, magazine or newspaper as it is difficult to read.

Another characteristic of this type of aphasia is poor understanding of numbers, and having trouble identifying the time of day or counting money.

2. Broca's aphasia

Broca's aphasia, or expression aphasia, is characterized by an alteration in the frontal lobe of the brain. This is the region responsible for language, and therefore damage in this area can lead to difficulty forming complete sentences and using connecting words within a sentence phrase.

In addition to language symptoms, Broca's aphasia can cause weakness or paralysis of the right arm and leg, as the affected area in the brain is also responsible for the movement of these limbs. This is why it is also sometimes called motor aphasia.

In Broca's aphasia, there is no difficulty in understanding language. This can cause frustration in the person, as they are unable to reply and express themselves correctly. They will often use small sentences of no more than 2 words, such as: "glass of water", when they wanted to say: "I want a glass of water."

3. Global aphasia

Global aphasia is characterized by greater brain damage in the areas responsible for language. This type is associated with both difficulty in understanding and expressing language.

Patients with global aphasia cannot understand what another person says and, when they try to speak, they are also unable to express what they want, resulting in a considerable decrease in quality of life. Rehabilitation for this condition is generally limited, as well as your treatment.

Possible causes

Aphasia is caused by conditions that affect the language area of the brain, and include:

  • Cerebrovascular accident (CVA)
  • Brain tumors, mainly on the left side of the brain
  • Trauma or blows to the head
  • Neurodegenerative diseases, such as Alzheimer's disease

Furthermore, brain infections can also compress certain areas of the pain and alter language expression if they are not diagnosed early or are left untreated.

Treatment options

Treatment for aphasia should be guided by a neurologist, and depends on its underlying cause. Surgery may be recommended for cases of brain tumors- The doctor may also prescribe medication to help manage stroke symptoms.

It is important for patients with aphasia to be monitored regularly with routine assessments to determine the response to treatment. This will help to guide treatment and will prompt changes as needed.

Another fundamental treatment for aphasia is rehabilitation, which begins, in most cases, with language therapy sessions with a speech therapist. These sessions involves activities that stimulate the affected areas of the brain and the therapist can ask the person to express themselves using only speech, without using signs, gestures or drawings.

Rehabilitation measures

Aphasia rehabilitation is carried out by a speech therapist It is important that the person with aphasia to be accompanied by a family member or friend when completing sessions so that rehab techniques can be continued outside of the sessions.

The speech therapist can provide some recommendations, such as:

  • Use simple sentences
  • Speak slowly
  • Allow the person with aphasia to speak without rushing
  • Do not try to complete the person with aphasia’s sentences
  • Avoid noisy environments
  • Use drawings and gestures to explain an idea
  • Ask questions to which the answer is “yes” or “no”
  • Avoid excluding the person with aphasia from conversations

Another recommendation is to establish topics before the conversation starts. This allows the person to know exactly what the conversation will be about and prepare what they are going to say. This can generate less stress when constructing sentences.

Furthermore, it is recommended to use a notebook so that the person can express themselves through drawings. Drawings can be used to express an emotion or to identify an object to facilitate communication.