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What is aphasia? Types, symptoms and treatment

Difficult news hit the entertainment world today as Bruce Willis’ family announced he would be retiring after being diagnosed with a language disorder called aphasia. The condition “affects his cognitive abilities,” his family members wrote on Instagram. “As a result and with great consideration, Bruce is stepping away from the career that meant so much to him.”

Aphasia affects two million Americans, according to the National Aphasia Association (NAA), but a 2016 survey by the organization found that less than nine percent of respondents even knew what the condition was. Although it’s not a much talked about disorder, Willis’ announcement brings new attention to aphasia and its impact on patients and their loved ones. Here’s everything you need to know about this condition, including symptoms, causes, and treatments.

What is aphasia? Symptoms and causes

“Aphasia is the inability to communicate or speak,” says May Kim-Tenser, MD, neurologist at Keck Medicine of USC. Aphasia presents in different ways (see below), but the condition can affect all aspects of communication: speaking and understanding speech, as well as writing and reading.

“Usually, aphasia occurs after a stroke, and its onset is quite sudden, or it can occur after a head injury,” says Dr. Kim-Tenser. Aphasia can also appear gradually as a result of a slowly growing brain tumor or a degenerative disease, such as dementia. “Usually [aphasia caused by those conditions] is chronic and occurs over time,” says Dr. Kim-Tenser. “If you see aphasia that comes on suddenly, it’s usually due to a stroke. Because of the relationship between stroke and aphasia, people with risk factors for stroke (including high blood pressure, diabetes, and high cholesterol) are also at higher risk for stroke. aphasia. Older people, especially people over 65, and those with a family history of stroke are also at higher risk.

Although all types of aphasia affect language, the specific symptoms vary between people and the forms of the disease. The NAA recognizes several different types, including the following.

  • Global aphasia: It is the most serious form of the disease. Patients with global aphasia may produce “few recognizable words”, are able to understand little or no spoken language, and cannot read or write.
  • Broca’s aphasia, or non-fluent aphasia: Patients with Broca’s aphasia may be able to read and understand speech, but have severe speech and writing difficulties.
  • Wernicke’s aphasia, or fluent aphasia: This form of aphasia impairs the ability to write, read or understand speech. According to the NAA, patients with Wernicke’s aphasia may produce “connected” but abnormal speech interspersed with irrelevant words and confusing sentences.
  • Anomic aphasia: People with anomic aphasia have a persistent inability to find the exact word they are looking for, especially nouns and verbs. This applies to both speaking and writing, although they can usually read and understand speech.
  • Primary progressive aphasia: This form of aphasia is caused by neurodegenerative diseases, such as Alzheimer’s disease, and is characterized by a slow and progressive impairment of the ability to communicate.

Is aphasia treatable?

Treatments for aphasia vary depending on the cause of the condition, Dr. Kim-Tenser says, but usually involve speech therapy. Patients “need to relearn and practice their language skills,” she explains. Depending on their type of aphasia, they may also learn other ways to communicate. Techniques can include writing but not necessarily verbal language communication or using a letter board, Dr. Kim-Tenser says.

It is important to remember that aphasia that occurs suddenly can be both the result of a stroke or a sign that a stroke is occurring. If you notice that you or someone else is suddenly having trouble speaking coherently, call 911 and go to the emergency room, says Dr. Kim-Tenser. If it’s an acute stroke, “we have acute treatments that can potentially reverse the aphasia,” she explains, including anti-clot drugs or surgical removal of a clot in the affected blood vessel.

For people with long-term aphasia, whether personally or with a loved one, communication frustration is common, says Dr. Kim-Tenser. Some patients are simply not able to communicate what they are trying to say. “It takes a lot of patience,” she says. Dr. Kim-Tenser also notes that aphasia support groups and stroke support groups (for those whose aphasia was caused by a stroke) are available for patients and their families.