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Aphasia is one of those conditions you can’t hide for long. You can say, “I’m having a senior moment,” but when you say it all the time and you’re a stroke survivor, you have to come to terms that it may likely be  aphasia.

Here’s a quick rundown of the 2 million people, in the US alone, who have lost all, or part, of the ability to use words to communicate:

  • Aphasia is an impairment of language that can affect both the production and comprehension of speech and impair a person’s ability to read and/or write.
  • Aphasia is always caused by an injury to the brain.
  • Stroke is the most common cause of brain injury that leads to aphasia.
  • Other brain injuries from head trauma, infections, or tumors can also cause aphasia.
  • Aphasia can be mild and only affect a single aspect of language OR it can be so severe that is incredibly difficult to communicate with the patient.
  • Most commonly, multiple aspects of communication are impaired.
  • Some people can recover from aphasia, but if they have it longer than 2 or 3 months it is unlikely they will recover.

Aphasia is defined as an impairment language caused by an injury to the brain, usually due to stroke, but it could happen from any type of brain injury.

Before April, 2009, I used to be a public speaker, communicating to crowds of people in an extemporaneous fashion, the words flowing with no effort, ad-libbing in an  impromptu fashion. Now, I know my limits and I’m scared.

Are there differences in types of aphasia? There surely are, and thanks to the UK Stroke Association for this quick guide:

Broca’s aphasia (non-fluent aphasia)

Broca’s aphasia or expressive aphasia is when people find it very difficult to find and say the right words, although they probably know exactly what they want to say.

People with Broca’s aphasia may only be able to say single words or very short sentences, although it’s usually possible for other people to understand what they mean. This can be very frustrating.

The features of Broca’s aphasia are:

  • Severely reduced speech, often limited to short utterances of less than four words.
  • Limited vocabulary.
  • Clumsy formation of sounds.
  • Difficulty writing (but the ability to read and understand speech). 

Wernicke’s aphasia (fluent aphasia)

Wernicke’s aphasia or receptive aphasia is when someone is able to speak well and use long sentences, but what they say may not make sense. They may not know that what they’re saying is wrong, so may get frustrated when people don’t understand them.

The features of Wernicke’s aphasia are:

  • Impaired reading and writing.
  • An inability to grasp the meaning of spoken words (producing connected speech is not affected).
  • An inability to produce sentences that hang together.
  • The intrusion of irrelevant words in severe cases. 

Anomic aphasia

The features of anomic aphasia are:

  • An inability to supply the words for the very things the person wants to talk about, particularly the significant nouns and verbs.
  • Speech that’s full of vague expressions of frustration.
  • A difficulty finding words in writing as well as in speech.  

Primary progressive aphasia (PPA)

Primary progressive aphasia (PPA) is a condition where language capabilities become slowly and progressively worse, leading to a gradual loss of the ability to:

  • Read.
  • Write.
  • Speak.
  • Understand what other people are saying.

Deterioration can happen slowly, over a period of years. Other mental functions such as memory, reasoning, insight and judgement are not usually affected.

It’s important to get an accurate diagnosis for PPA. This is to rule out other degenerative brain disorders like Alzheimer’s disease where language and memory and reason are affected.

The operative word here is “may.” I have mostly Broca’s aphasia, but I have no trouble with written expression. In fact, words come about easily through writing rather than speaking. 

I was a Communication prof so being able to say words clearly was important in my playbook. Am I disgruntled at my speaking ability? You bet. Would I ever accept the stroke? No way. But if I don’t fall anymore, that would be good enough for me. 

Joyce Hoffman

Joyce Hoffman

Joyce Hoffman is one of the world's top 10 stroke bloggers according to the Medical News Today. You can find the original post and other blogs Joyce wrote in Tales of a Stroke Survivor. (https://talesofastrokesurvivor.blog)
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Joyce Hoffman
2 years ago

oc1dean, the brain is a complex organ which we don't much about, even the health professionals. Maybe before stroke he did swearing routinely. It's just a guess but a good one. The ability to write is affected with Broca's, but look at me who has been writing for most of her life, over 55 years. Maybe swearing just comes natural to him like writing does to me! Thanks for your comment!

Joyce Hoffman
2 years ago

Laura, aphasia shouldn't define you! Three cheers for your comment because some people think otherwise.

Joyce Hoffman
2 years ago

Steve, That's a tough one, but here is my answer: limit those with subtitles–one or two a month–that you read to your wife and yes, absolutely the film industry should warn you!

2 years ago

One guy in my bowling group probably had Brocas, very limited ability to communicate but when frustrated with bowling could swear quite profusely and quickly.

Laura Besser
Laura Besser
2 years ago

None of those (AVM survivor)define me

2 years ago

Hi Joyce. my wife had a stroke in 2011, she now has global aphasia (all four). I have been trying for some time to highlight the problem faced when watching films (and TV programmes) that suddenly break out into sub-titles. I don't mean foreign films, we would choose not to watch them, I mean English language films that, occasionally, have foreign speakers. We used to, (BC – before covid), go to the cinema up to three times a week and I was astounded at the number of films in which this occurs, I'll name three recent ones, Terminator-Dark Fate, Bad Boys for Life and Rambo-Last Blood. All three spend a lot of time in Mexico and the actors speak Spanish, which is portrayed on screen as subtitles. I have to read them out to my wife. I would like, initially, to have a warning, just as there are other warnings, that a film contains subtitles. We could then choose not to go as it's distracting to me and possibly other filmgoers when I read the subtitles out to my wife. What do you think? Too much to ask?

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