Aphasia
A loss of language ability from brain injury
Quick Facts
- Type: Communication (language) disorder
- Most common cause: Stroke
- Affects: Speaking, understanding, reading, writing
- Key treatment: Speech and language therapy
Overview
Aphasia is a condition that affects a person's ability to communicate. It can impair speaking, understanding what others say, reading, and writing, in any combination. Aphasia results from damage to the parts of the brain that control language, most often on the left side. It does not affect intelligence; people with aphasia still know what they want to say but have trouble producing or understanding the words.
The most common cause is a stroke, but aphasia can also follow a head injury, a brain tumor, an infection, or a progressive brain disease. The type and severity depend on the location and extent of the brain damage. With speech and language therapy, many people improve, and some recover substantially, especially when aphasia is caused by a stroke or injury.
Symptoms
Symptoms vary depending on which language abilities are affected and may include:
- Speaking in short or incomplete sentences, or struggling to find words
- Saying words in the wrong order or substituting one word or sound for another
- Difficulty understanding conversation, especially when it is fast or complex
- Trouble reading or writing
- Speaking fluently but in sentences that do not make sense
- Knowing what to say but being unable to get the words out
If aphasia comes on suddenly, especially with weakness or drooping on one side of the face or body, it may be a sign of a stroke. This is a medical emergency; call emergency services immediately.
Causes
Aphasia is caused by damage to the language areas of the brain. The main causes include:
- Stroke: The most common cause, when blood flow to part of the brain is blocked or a vessel bleeds.
- Head injury: Trauma that damages the language areas.
- Brain tumor: Growth pressing on or destroying language regions.
- Infection: Such as a brain infection that injures language areas.
- Progressive brain disease: Some forms of dementia gradually cause a type called primary progressive aphasia.
Risk Factors
- Conditions that raise stroke risk, such as high blood pressure, atrial fibrillation, diabetes, high cholesterol, and smoking
- Older age
- A history of stroke or transient ischemic attack
- Head trauma, such as from falls or accidents
- Certain neurological conditions, including some forms of dementia
Diagnosis
Diagnosing aphasia involves identifying the language difficulty and finding its cause:
- Medical assessment: A doctor evaluates speech, comprehension, reading, and writing, often during emergency care if a stroke is suspected.
- Brain imaging: CT or MRI scans to find the location and cause of the brain damage.
- Speech and language evaluation: A speech-language pathologist tests the specific abilities affected, which helps classify the type of aphasia and guide therapy.
Treatment
Treatment addresses both the underlying cause and the language difficulty itself.
- Treating the cause: Emergency treatment of a stroke, surgery or other treatment for a tumor, or care for an infection or injury.
- Speech and language therapy: The cornerstone of treatment, helping people regain language skills, develop new communication strategies, and make the most of remaining abilities.
- Communication aids: Tools such as picture boards, writing, gestures, and apps that support communication.
- Support for families: Teaching family and friends how to communicate effectively, such as speaking slowly, using simple sentences, and allowing extra time.
Recovery varies; many people improve over months, especially with early and ongoing therapy, while progressive forms are managed to maintain communication as long as possible.
Prevention
Because most aphasia results from stroke, the best prevention is reducing stroke risk:
- Keep blood pressure, blood sugar, and cholesterol well controlled
- Do not smoke and limit alcohol
- Stay physically active and eat a balanced diet
- Treat conditions such as atrial fibrillation that raise stroke risk
- Wear seat belts and helmets and take precautions to prevent head injuries
When to See a Doctor
Call emergency services immediately if language problems come on suddenly, especially with face drooping, arm weakness, or difficulty speaking, as these are signs of a stroke that needs urgent treatment.
See a doctor in a non-emergency setting if you or a loved one has gradually worsening difficulty finding words, understanding, reading, or writing, since this can signal a tumor or a progressive brain condition that should be evaluated. Early speech and language therapy improves communication and quality of life.
Frequently Asked Questions
What is aphasia?
Aphasia is a language disorder that affects the ability to speak, understand, read, or write, usually after damage to the language areas of the brain. It does not affect intelligence; people with aphasia know what they mean but struggle to produce or understand words.
What causes aphasia?
The most common cause is a stroke. It can also result from a head injury, brain tumor, brain infection, or a progressive brain disease. The type and severity depend on where and how much of the brain's language areas are damaged.
Can aphasia be cured?
It depends on the cause. Aphasia after a stroke or injury often improves over time, especially with speech and language therapy, and some people recover substantially. Aphasia from a progressive disease is managed to maintain communication for as long as possible.
Is sudden aphasia an emergency?
Yes. Language problems that begin suddenly, especially with facial drooping, arm weakness, or trouble speaking, may be signs of a stroke. Call emergency services right away, because fast treatment can limit brain damage and improve recovery.
How is aphasia treated?
The underlying cause, such as a stroke or tumor, is treated, and speech and language therapy helps people rebuild language skills and develop communication strategies. Communication aids and teaching family supportive techniques also help people stay connected.
References
- National Institute on Deafness and Other Communication Disorders (NIDCD). Aphasia.
- American Speech-Language-Hearing Association (ASHA). Aphasia.
- Mayo Clinic. Aphasia — Symptoms and causes.
- MedlinePlus, U.S. National Library of Medicine. Aphasia.