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What Is Aphasia?

When superstar Bruce Willis announced last month that he was stepping away from acting due to aphasia, many people no doubt rushed to the dictionary to find out what it was. Even if they knew that aphasia is the inability to communicate, they may have thought it is caused only by a stroke. But that’s not the only cause of this devastating condition.

So our primary care doctors at Cohen Medical Associates in Delray Beach want to provide you with information about this common but little-known condition.

What is aphasia?

Aphasia is a disorder that results from damage to the part of the brain responsible for language. It can cause a person to be unable to speak or write clearly, or even to understand what others are saying to them. The National Aphasia Association (NAA) reports that aphasia affects as many as two million Americans, making it more common than Parkinson’s disease, cerebral palsy, or muscular dystrophy. Nearly 180,000 Americans acquire the disorder each year.

According to the American Speech-Language-Hearing Association (ASHA), “Aphasia is an acquired neurogenic language disorder resulting from an injury to the brain—most typically, the left hemisphere.”

Aphasia can cause impairment in one or more of four primary areas of communication:

  • spoken language expression
  • spoken language comprehension
  • written expression
  • reading comprehension

The symptoms and degree of impairment varies with each individual, depending on the cause.

What causes aphasia?

The most common cause of aphasia is stroke. About 25-40 percent of stroke survivors experience aphasia. It can also be the result of a head injury, brain tumor, brain hemorrhage, an infection in the brain, or a degenerative brains disease such as dementia or Alzheimer’s.

When a stroke patient also develops aphasia, it’s usually due to a type of stroke that affects the dominant part of the brain on the left side, which controls language skills. In this type of stroke, the right arm or leg may also be affected with weakness or paralysis.

While it’s more prevalent in older individuals, it can happen to anyone at any time. The Los Angeles Times notes that actress Sharon Stone also experienced reading and speech issues after collapsing from a brain tumor in 2001. Following years of recovery, she was eventually able to return to acting.

What are the symptoms?

Depending on the cause, aphasia can come on suddenly, or begin more gradually. People with this disorder may struggle to find the words they want, use short fragments of speech, speak in a choppy, halting way, or even make up nonsense words and scatter them in their speech or writing.

The National Institute of Health (NIH) offers an example of what this might sound like: “You know that smoodle pinkered and that I want to get him round and take care of him like you want before.”

Their writing may be filled with grammatical errors and run-on sentences, or they may have trouble accurately copying letters and words. They may also have trouble understanding what people are saying to them, or what they are reading.

While the Willis family statement did not give details about the symptoms or suspected cause of Bruce Willis’s aphasia, an unconfirmed report from at least one person on the set of one of his films said he’d been having trouble with his lines, including repeating the director’s instructions as if they were part of his dialogue.

Mind unaffected

Aphasia is frustrating to victims because it usually doesn’t affect cognitive ability, just the ability to communicate what they’re thinking, reading, or hearing.

The NAA stresses that aphasia affects only the ability to communicate, not a person’s intelligence. That’s because the area that is damaged involves one or more of the language areas of the brain.

“A person with aphasia may have difficulty retrieving words and names, but the person’s intelligence is basically intact,” the NAA says.

“Aphasia is not like Alzheimer’s disease; for people with aphasia it is the ability to access ideas and thoughts through language—not the ideas themselves—that is disrupted,” it adds.


What is the treatment?

When the aphasia is caused by a brain injury, the NIH reports that tremendous changes occur in the brain as a result, which helps it recover. Therefore, people with aphasia often see dramatic improvements in their language and communication abilities in the first few months, even without treatment.

When these skills don’t regenerate on their own, speech and language therapy can help many patients regain their ability to communicate.

Nevertheless, there is no cure for aphasia, and complete recovery is unlikely for those whose symptoms persist longer than two or three months following onset, the NAA says. But treatment can help them overcome their communication difficulties.

“Many of them can go back to their old jobs and lead lives from before,” Swathi Kiran, director of the Aphasia Research Laboratory at Boston University, told The Washington Post. Sometimes the road to rehabilitation is long and hard, but it’s possible to improve.

It’s important for family members to be involved in aphasia treatment, because it can not only help relieve the mutual frustration when the patient can’t easily communicate their thoughts, but also help keep them socialized and involved with others.

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