Aphasia: When Speaking Is Hard

By Flaster, Karen | American Nurse Today, December 2015 | Go to article overview

Aphasia: When Speaking Is Hard


Flaster, Karen, American Nurse Today


Imagine you are talking, and then suddenly you can't. Your ability to communicate has paused. Over time, or in an instant, your ability to communicate and life as you know it has changed. These communication problems are the result of a neurological disorder known as aphasia, which occurs when your brain's language center is damaged.

Aphasia is an acquired disorder. It's a condition, not a disease. Aphasia does not affect intelligence. It occurs in all nationalities, races, sexes, and every age group, though the incidence of asphasia increases with age.

Approximately 1 million individuals suffer from aphasia in the United States, according to the National Institute on Neurological Disorders and Stroke (NINDS). Nearly 180,000 Americans acquire the disorder each year.

What is aphasia?

Aphasia is an impairment to parts of the brain affecting the ability to process language and communicate. (See The brain and aphasia.) Aphasia can cause difficulties speaking, listening. reading, and writing. For most people, these are areas on the left hemisphere of the brain. Aphasia usually occurs suddenly, often as the result of stroke or head injury, but it can also develop slowly, as occurs with a brain tumor, infection, or dementia.

The brain and aphasia

The brain is made up of the cerebrum, brainstem, and cerebellum. The cerebral cortex, also referred to as "gray matter," layers the brain and is divided into right and left sides (hemispheres) that are composed of the frontal, temporal, parietal, and occipital lobes. Each lobe has a specific function. The frontal and temporal lobes control language (among many other functions). In most people, damage to the anterior and posterior portion of the left hemisphere will result in aphasia.

Left-side view of the brain showing areas affected by the most common types of aphasia (Source: National Institutes of Health/National Institute on Deafness and Other Communication Disorders)

Causes of aphasia

Aphasia can be caused by any disease or trauma that damages the parts of the brain that control language:

* stroke

* traumatic brain injuries

* brain tumors

* hemorrhage

* cerebral palsy

* muscular dystrophy

* epilepsy

* surgery

* encephalitis

* Parkinson's disease

* Alzheimer's disease and other dementias

Stroke is the most frequent cause of aphasia: 25% to 40% of stroke survivors acquire aphasia, according to the National Aphasia Association. Traumatic brain injuries are another cause of aphasia. A million and a half traumatic brain injuries occur each year in the United States, a figure that does not include such injuries among members of the military. The number of Traumatic brain injuries among military personnel from the year 2000 through the second quarter of 2015 is 333,169. More than 80% of these injuries occur in nondeployed events. The Defense and Veterans Brain Injury Center identifies traumatic brain injury as concussion/mild, moderate, severe, penetrating or open /penetrated head injury and not classifiable.

Young adults, particularly males, and children incur traumatic brain injuries from bicycle, motorcycle, firearm, and auto accidents and are at risk for postinjury complications and disabilities including aphasia. In the elderly, falls are the leading cause of traumatic brain injury; posttraumatic dementia, other types of dementia, movement disorders, and Parkinson's disease may also cause aphasia. As Baby Boomers age, the number of people with all of these diseases and condition are expected to increase, along with the incidence of aphasia.

Types of aphasia

There are many types of aphasia ranging in degree of severity. Anomic aphasia is less severe, primarily involving a struggle to use the correct name for objects, places, or events. In contrast, global aphasia is a severe deficit, allowing little or no ability to speak, understand speech, read, or write; it is often the result of a right hemisphere infarction, tumor, stroke, or dementia. …

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