Aphasia/Dysphasia

APHASIA

 Aphasia is a disorder that results from damage to portions of the brain that
are responsible for language.
 It can affect your speech, writing, and ability to understand language.
 Aphasia gets in the way of a person's ability to communicate, but it doesn't
impair intelligence.
 People who have aphasia may have a hard time speaking and finding the
"right" words to complete their thoughts.
 They may also have problems understanding conversation, reading and
comprehending written words, writing words, and using numbers.
 People with aphasia may also repeat words or phrases.
 Aphasia is a language disorder. It happens when you injure parts of the
brain that relate to language.
 The language areas of the brain span regions of the frontal lobe, the
temporal lobe, and the parietal lobe.

SYMPTOMS:

 The main symptoms of aphasia include:

 Trouble speaking.
 Struggling with finding the right term or word.
 Using strange or wrong words in conversation.
 Trouble understanding what other people say or following conversations.
 Writing sentences that don't make sense or trouble expressing yourself in
writing.
 Speaking in short sentences or phrases.
 Using unrecognizable words.
Aphasia may be mild or severe.

 With mild aphasia, the person may be able to converse, yet have trouble
finding the right word or understanding complex conversations.
 Serious aphasia makes the person less able to communicate. The person
may say little and may not take part in or understand any conversation.
 Aphasia does not affect thinking skills. But the person may have problems
understanding written material and a hard time with handwriting. Some
people have trouble using numbers or even doing simple calculations.

TYPES:

 Broca's aphasia
 Wernicke's aphasia
 Anomic aphasia
 Global aphasia
 Primary Progressive Aphasia

BROCA'S APHASIA:

 It takes a lot of effort to say words or string together sentences. A person

with Broca's aphasia may only be able to say three or four words at a time.
 People with this kind of aphasia have limited vocabulary and trouble finding
the words they want to use.
 At the same time, people with Broca's aphasia tend to understand speech.
Broca's aphasia is sometimes called "non-fluent aphasia.
 For example, a person with Broca's aphasia may say, "Walk dog," meaning,
"I will take the dog for a walk," or "book book two table," for "There are
two books on the table." People with Broca's aphasia typically understand
the speech of others fairly well.
Wernicke's Aphasia:

 Speaking isn't difficult; in fact, the words pour out of the mouth with ease.
 The problem is that the person isn't forming coherent words, or those
words aren't coming together into coherent sentences.
 Wernicke's aphasia also affects reading and writing. Wernicke's aphasia is
sometimes called "fluent aphasia."
 For example, when someone experiences Wernicke's aphasia, they may
say: "My door sat through the lamp in the sky." It makes it impossible for
listeners to understand what the person is trying to communicate.

Anomic Aphasia:

 People with anomic aphasia can't find the words they want to use, and this
is particularly true when trying to come up with the correct noun or verb.
 They get around the missing words by using many other similar words or
filling in the blank spaces with vague fillers like "stuff" or “thing."
 People with anomic aphasia understand speech and they can usually read,
but you see the same difficulties in finding the right word in their writing.
 EXAMPLE: Individuals with aphasia who display anomia can often describe
an object in detail and maybe even use hand gestures to demonstrate how
the object is used, but cannot find the appropriate word to name the
object.

Global Aphasia

 This is the most severe form of aphasia. People with global aphasia cannot
speak many words and sometimes don't understand speech.
 They cannot read or write.
 People may have global aphasia for a short period of time following a brain
injury or stroke, and then move into a different type of aphasia as their
brain health begins to improve.
  People with global aphasia may only say a few words, such as "no" or "hey"
or "what"

Primary Progressive Aphasia

 Primary Progressive Aphasia is actually a form of dementia where people

lose the ability to speak, write, and read over time.
 It's a gradual loss of language, moving from subtle to severe when in
advance stages.
 Examples: the person cannot recall the meaning of words that are not
frequently used and may ask, "What is an airplane?" He or she may not
remember what a toothbrush is or how to use it.

Etiology

 The areas of the brain necessary for processing language: Broca's area,
Wernicke's area, the primary motor cortex, the posterior middle temporal
gyrus, and the middle and posterior superior temporal gyrus.
 Language function is located on one hemisphere (half) of the brain, which is
called the dominant hemisphere. Typically, the dominant hemisphere of
the brain is on the side opposite the dominant hand (the hand you write
with).
 Aphasia can occur as a result of any injury to the brain, such as a stroke,
traumatic brain injury, a brain tumor, or an infection of the brain. Because
of the way the blood vessels are arranged in the brain.
 Aphasia is caused by damage to the language-dominant side of the brain,
usually the left side, and may be brought on by:
 A brain tumor: A brain tumor is a collection, or mass, of abnormal cells in
our brain. Your skull, which encloses your brain, is very rigid. Any growth
inside such a restricted space can cause problems
 An infection: Brain infections can cause aphasia if the infection or swelling
impacts the brain's language centers. Aphasia due to brain infection is often
 short-term and gets better when the infection is cleared. However, if the
infection is severe, long-term aphasia can result.
 Dementia or another neurological disorder
 A degenerative disease
 A head injury: Damage to the temporal lobe (the side portion) of the brain
may result in a fluent aphasia called Wernicke's aphasia. In most people,
the damage occurs in the left temporal lobe, although it can result from
damage to the right lobe as well.
 A stroke: A stroke occurs when a blood clot or a leaking or burst vessel cuts
off blood flow to part of the brain. Brain cells die when they do not receive
their normal supply of blood, which carries oxygen and important nutrients.
Strokes are the most common cause of aphasia.

DYSPHASIA
 Dysphasia is a language disorder that affects the ability to produce and
understand spoken language. It can cause reading, writing, speech and
gesturing problems.

Symptoms

 The most common symptoms of dysphasia include difficulties speaking,

difficulties with expression and understanding spoken language.
 It is also common for people with dysphasia to display withdrawal from
social situations because their dysphasia causes communication problems.

Verbal signs of dysphasia include:

 Speaking slowly and with great difficulty.

 The use of bad grammar when forming a sentence and the omission of
grammar.
 Struggling to remember words and using a limited vocabulary.
 Speaking fluently but in 'a nonsensical manner.
Signs of dysphasia in relation to comprehension:

 Difficulty understanding spoken language.

 Difficulty understanding complex grammar or fast speech.
 Difficulty processing and remembering long sentences.
 Misinterpretation of sentences.

TYPES:

Expressive dysphasia:

 This affects a person's ability to speak and articulate language coherently. It

is caused by damage to the area of the brain responsible for speech
production called Broca's area.

Receptive dysphasia:

 Affects language comprehension. The person can speak fluently, but they
often speak with no meaning and are unaware of their speech errors. It is
caused by damage to the area in the brain responsible for understanding
written and spoken language.

Combined/global dysphasia:

 The person has difficulty expressing them, speaking and understanding

language. This type of dysphasia is caused by widespread damage to the
language centers of the brain.

ETIOLOGY

 Dysphasia occurs when areas of the brain responsible for language

production and comprehension are damaged.
 A number of conditions can cause brain damage.
 Strokes are the most common cause of dysphasia. During a stroke, a
blockage in the blood vessels of the brain can starve brain cells of blood
and oxygen, causing them to die. This leads to brain damage.
More conditions that cause dysphasia include:

 Neurodegenerative diseases, such as Alzheimer's and Parkinson's

 Brain tumors
 Dementia
 Traumatic head injuries
 Epilepsy
 Migraines
 Some cases of dysphasia, caused by epilepsy or migraines are only
temporary and normal language abilities are restored after the epileptic
seizures and headaches subside.

Treatment

 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.
 Researchers are currently investigating the use of medications, alone or in
combination with speech therapy, to help people with aphasia.

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.
 For aphasia, speech and language therapy aims to improve the person's
ability to communicate by restoring as much language as possible, teaching
how to make up for lost language skills and finding other methods of
communicating.
Therapy:

 Some studies have found that therapy is most effective when it begins soon
after the brain injury.
 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 use of computers. Using computer-assisted therapy can be
especially helpful for relearning verbs and word sounds (phonemes).

Medications

 Certain drugs are currently being studied for the treatment of aphasia.
 These include drugs that may improve blood flow to the brain, enhance the
brain's recovery ability or help replace depleted chemicals in the brain
(neurotransmitters).
 Several medications, such as memantine Namenda and piracetam, have
shown promise in small studies. But more research is needed before these
treatments can be recommended.

Other treatments

 Brain stimulation is currently being studied for aphasia treatment and may
help improve the ability to name things.