Aphasia : When your Brain holds your words hostage
Language is a form of communication that unique to humans. Any disturbance in the ability to speak coherently and meaningfully is one of the most disabling conditions known to mankind. The term ‘Aphasia’ refers to the language disorder caused by damage to the brain. It is very important for people to know about Aphasia as many patients go undiagnosed and untreated. The Aphasia and Stroke Association of India estimates that aphasia affects an estimated 800,000 to 1,000,000 people annually in India. Since there is no single reporting agency for aphasia and stroke, this number is highly underestimated than the number of actual patients in the country. In a study conducted in Kerala, India, only 10 (8.7%) of the 114 people interviewed had heard of the disability affecting language.
What is ‘Aphasia’?
Many structures in the brain are involved in understanding, processing and generating meaningful words. In many right handed individuals, the main areas that control speech are located in the left half of the brain. There are two areas in the brain that control speech, one helps in understanding what is heard and read and the other helps to generate meaningful words. Numerous brain cells connect these two areas so that there is relation between what is understood and what is spoken. In many left handed individuals, the speech areas are located on the left half of the brain; although, in some, they are located in the right half of the brain.
What causes “Aphasia’?
Any damage to the speech areas or the connections can cause aphasia. The most common causes are
- head injury
- brain bleed and
What are the symptoms of ‘Aphasia’?
The symptoms of aphasia depend on the location and extent of damage to the brain. Patients may have a difficulty in understanding spoken or written words when it is called ‘Receptive aphasia’ as it is a disorder of speech reception. If the patient is able to understand, but cannot speak well, it is called ‘Expressive aphasia’ as it is a disorder of expression. Patients may have one of these or a combination of ‘receptive’ and ‘expressive’ aphasia.
People with Receptive aphasia
- Know that others are speaking to them
- May follow some of the words
- May have a difficulty to put together the words to form a meaningful thought
- May understand hand signs
- Are able to speak meaningful sentences
- May have difficulty reading forms, books and written material
People with Expressive aphasia
- May be able to understand what is spoken
- May be able to speak a few words
- May speak incomprehensible words
- May have a difficulty writing meaningful sentences
Other consequences of Aphasia
- Patients are often frustrated because they are either not able to understand what is spoken or unable to speak meaningful words
- The patient may be unable to communicate his/her symptoms
- Often times, the caregiver may be frustrated because the patients do not understand what is spoken
- In long term, aphasia may have a significant psychological impact on the person and depression.
How is Aphasia diagnosed?
A Neurologist, Neurosurgeon or a Speech and Language Therapist are able to diagnose aphasia and determine the cause. Common tests employed to diagnose the cause of aphasia are CT, MRI, lumbar puncture (to test the spinal fluid). A detailed evaluation by the Speech Therapist may be needed.
How is Aphasia treated ?
In many patients, treating the cause of aphasia (such as stroke, brain bleed or tumor) will result in resolution of aphasia. However, the extent to which the aphasia will improve may vary. Many treatments are available for patients with persistent aphasia. Typically, the Speech and Language Therapist administers these treatments to help patients overcome the disability due to aphasia. Apart from these, many computers and mobile phones have applications to help patients with aphasia get around their daily work.
Where can I get more information about Aphasia and its treatment?
Many organizations provide help to the patients and caregivers. Some of these are:
- Aphasia and Stroke Association of India (http://www.aphasiastrokeindia.com/)
- American Speech-Language-Hearing Association (http://www.asha.org/)
- National Aphasia Association (http://www.aphasia.org/)
- American Stroke Association ( https://www.stroke.org/ )
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