Aphasia is a language disorder ranging from difficulty finding words to a complete loss of the ability to speak. It is caused by damage to the brain caused in most cases by a stroke. Recovery depends on the severity of the injury.

What is aphasia

Aphasia is the medical term for a person who has lost the ability to use or understand their language. It occurs when the brain is damaged, usually with a stroke.

The different forms of aphasia

There are generally two forms of aphasia:

1. Fluent aphasia: The person has difficulty understanding a sentence although they can speak easily.
2. Non-fluent aphasia: the person has difficulty expressing themselves, although the flow is normal.

Aphasia global

It is the most serious form of aphasia. It results from significant damage to the language areas of the brain. The patient cannot speak or understand spoken or written language.

Broca’s aphasia, or non-fluent aphasia

Also called “non-fluent aphasia”, Broca’s aphasia is characterized by difficulty speaking, naming words, even though the person affected can largely understand what is being said. They are often aware of their difficulty in communicating and may feel frustrated.

Aphasie de Wernicke, ou aphasie fluente

Also called “fluent aphasia,” people with this type of aphasia can express themselves but have difficulty understanding what they are saying. They talk a lot, but their words don’t make sense.

Anomic aphasia

People with this type of aphasia have trouble naming specific objects. They are able to speak and use verbs, but they cannot remember the names of some things.

The causes of aphasia

The most common cause of aphasia is a stroke (Stroke) of ischemic (blockage of a blood vessel) or hemorrhagic (bleeding from a blood vessel) origin. In this case, aphasia appears suddenly. Stroke causes damage to the areas that control language located in the left hemisphere. According to statistics, about 30% of stroke survivors have aphasia, of which the vast majority of cases are ischemic strokes.

The other cause of aphasia originates from a dementia that frequently manifests itself in progressive language disorders and is called “primary progressive aphasia”. It is found in patients with Alzheimer’s disease or frontotemporal dementias. There are three variant forms of primary progressive aphasia:

• progressive fluent aphasia, characterized by decreased comprehension of words.
• progressive logopenic aphasia, characterized by decreased word production and difficulty finding words;
• progressive non-fluent aphasia, characterized primarily by a decrease in language production.

Other types of brain damage can cause aphasia such as head trauma, brain tumor, or infection that affects the brain. In these cases, aphasia usually occurs along with other types of cognitive problems, such as memory problems or confusion.

Sometimes temporary episodes of aphasia can occur. These can be caused by migraines, seizures, or a transient ischemic attack (TIA). An AID occurs when blood flow is temporarily blocked in an area of ​​the brain. People who have had TIA have an increased risk of having a stroke in the near future.

Who is most affected?

The elderly are the most affected because the risk of stroke, tumors and neurodegenerative diseases increase with age. However, it can affect younger individuals and even children very well.

Diagnosis of aphasia

The diagnosis of aphasia is fairly easy to make, since symptoms usually appear suddenly following a stroke. It is urgent to consult when the person has:

• difficulty speaking to the point that others do not understand it
• difficulty understanding a sentence to the point that the person does not understand what others are saying
• difficulty remembering words;
• reading or writing problems.

Once aphasia has been identified, patients should undergo a brain scan, usually a magnetic resonance imaging (MRI), to find out which parts of the brain are damaged and how severe the damage is.

In the case of aphasia that appears suddenly, the cause is very often an ischemic stroke. The patient should be treated within hours and further evaluated.

Electroencephalography (EEG) may be necessary to detect if the cause is not epileptic.

If the aphasia appears insidiously and gradually, especially in the elderly, one would suspect the presence of a neurodegenerative disease such as Alzheimer’s disease or primary progressive aphasia.

The tests carried out by the doctor will make it possible to know which parts of the language are affected. These tests will assess the patient’s ability to:

• Understand and use words correctly.
• Repeating difficult words or phrases.
• Understanding speech (eg answering yes or no questions).
• Read and write.
• Solve puzzles or word problems.
• Describe scenes or name common objects.

Evolution et com?plications possible

Aphasia affects the quality of life because it prevents good communication which can affect one’s professional activity and relationships. Language barriers can also lead to depression.

People with aphasia can often relearn to speak or at least communicate to some extent.

The chances of recovery depend on the severity of the aphasia which itself depends on:

• the damaged part of the brain,
• the extent and cause of the damage. The initial severity of aphasia is an important factor determining the prognosis of patients with aphasia due to stroke. This severity depends on the time between treatment and the onset of damage. The shorter the period, the better the recovery will be.

In stroke or trauma, aphasia is transient, with recovery that may be partially (for example, the patient continues to block on certain words) or fully complete.

Recovery can be complete when rehabilitation is carried out as soon as symptoms appear.