Aphasia is a condition that robs you of the ability to communicate. Aphasia can affect your ability to express and understand language, both verbal and written. The amount of disability depends on the location and the severity of the brain damage that is the cause. Aphasia typically occurs suddenly, after a stroke or a head injury. But it can also come on gradually, from a slowly growing brain tumor or a degenerative disease. Once the underlying cause has been treated, the primary treatment for aphasia is speech therapy that focuses on relearning and practicing language skills and using alternative or supplementary communication methods. Family members often participate in the therapy process and function as communication partners of the person with aphasia.

Complications of Aphasia

Aphasia can create numerous quality-of-life problems because communications is so much a part of your life. Communication difficulty may affect your:

• Job
• Relationships
• Day-to-day function

Language barriers may lead to embarrassment, depression and relationship problems.

Causes of Aphasia

• The most common cause of aphasia is brain damage resulting from a stroke — the blockage or rupture of a blood vessel in the brain. This disruption of the blood supply leads to brain cell death or damage in areas of the brain controlling language. Brain damage caused by a severe head injury, a tumor, an infection or a degenerative process can also cause aphasia.
• Primary progressive aphasia is the term used for language difficulty that develops gradually. This is due to the gradual degeneration of brain cells located in the language networks. Sometimes this type of aphasia will progress to a more generalized dementia.

Signs & Symptoms of Aphasia

Aphasia is a sign of some other condition, such as a stroke or a brain tumor.

A person with aphasia may:

• Speak in short or incomplete sentences
• Speak in sentences that don't make sense
• Speak unrecognizable words
• Not comprehend other people's conversation
• Interpret figurative language literally
• Begin to make spelling errors
• Write sentences that don't make sense

The severity and scope of the problems depend on the extent of damage and the area of the brain affected. Some people may comprehend what others say relatively well but struggle to find words to speak. Other people may be able to understand what they read, but yet can't speak so that others can understand them.

Diagnosis of Aphasia

Your doctor will likely request an imaging test, such as a computerized tomography (CT) scan or magnetic resonance imaging (MRI) to quickly identify what's causing the aphasia.

You'll also likely undergo tests and informal observations to assess your language skills, such as the ability to:

• Name common objects
• Engage in a conversation
• Understand and use words correctly
• Answer questions about something read or heard
• Repeat words and sentences
• Follow instructions
• Answer yes-no questions and respond to open-ended questions about common subjects
• Tell a story or explain the plot of a story
• Explain a joke or a figurative phrase, such as "I need to unwind"
• Read and write letters, words and sentences

Treatments of Aphasia

If the brain damage is mild, a person may recover language skills without treatment. However, most people undergo speech and language therapy to rehabilitate their language skills and supplement their communication experiences.

Speech and language rehabilitation

Recovery of language skills is usually a relatively slow process. Although most people make significant progress, few people regain full pre-injury communication levels. In aphasia, speech and language therapy:

• Starts early. Therapy is most effective when it begins soon after the brain injury.
• Builds on success. The speech-language pathologist uses exercises to improve and practice communication skills. These may begin with simpler tasks such as naming objects and evolve into more complex exercises of explaining the purpose of an object.
• Shifts focus. The speech-language pathologist might teach the person ways to compensate for the language impairment and to communicate more effectively with gestures or drawings. Some people with aphasia may use a book or board with pictures and words to help them recall commonly used words or help them when they're stuck.
• Often works in groups. In a group setting, people with aphasia can try out their communication skills in a safe environment. Participants can practice initiating conversations, speaking in turn, clarifying misunderstandings and fixing conversations that have completely broken down.
• May include outings. Participating in real-life situations — such as going to a restaurant or a grocery store — puts rehabilitation efforts into practice.
• May include use of computers. Using computer-assisted therapy can be especially helpful for relearning verbs and word sounds (phonemes).

When to seek Medical Advice

Because aphasia is often a sign of a serious problem, such as a stroke, seek emergency medical care if you suddenly develop:

• Difficulty speaking
• Trouble comprehending speech
• Difficulty with word recall
• Problems with reading or writing