How Many Categories Does Aphasia Have and What Are the Symptoms?

Aphasia is a disorder that affects a person’s ability to communicate. It often results from an underlying neurological condition in which parts of the brain that control language are damaged. People with aphasia may have trouble with “language production” (including speaking and writing), comprehension (understanding others’ speech or reading), or both.

More than 2 million people in the United States suffer from aphasia; it commonly occurs suddenly, often following a stroke or traumatic brain injury. It can also develop slowly over time from a disease process such as a brain tumor or neurodegenerative disease. In some cases, it can be a temporary condition brought about by a seizure, migraine, or a temporary blockage of blood flow to the brain. While aphasia describes a shortage in someone’s ability to process language, the underlying cause or condition may also affect other mind skills.

Aphasia forms and symptoms

Aphasia takes many different forms, and the symptoms can vary depending on the person's specific form. These forms can be understood within three broad categories:

• Expressive aphasia: Also known as Broca's aphasia or nonfluent aphasia, this form is described by difficulty speaking. People with expressive aphasia may struggle to produce words or sounds, often limited to single words or simple phrases. While they generally understand others' speech, expressing themselves can be challenging despite knowing what they want to say.
• Receptive aphasia: Wernicke's aphasia, also known as fluent aphasia, presents a challenge in understanding for individuals affected. Those with receptive aphasia may struggle to understand complex sentences or individual words. While they can speak long and complete sentences, the speech may lack meaning, often involving incorrect or unnecessary words.
• Global aphasia: People with this type of aphasia struggle with all aspects of language, like speaking, understanding, reading, and writing. They find it hard to repeat what they hear and struggle to communicate. They often depend more on nonverbal cues like facial expressions and tone of voice.

When aphasia is the result of a stroke or brain injury, symptoms do not get worse. When aphasia is the result of a dementia process (or neurodegenerative disease), language symptoms are advanced. That means the disease begins with subtle problems that get worse over time. This condition is known as primary progressive aphasia (PPA). There are three types of PPA:

• Nonfluent/agrammatic variant PPA: People with this variant have no trouble understanding the meaning of words, but they have difficulty getting words out and putting sentences together. They may need help pronouncing simple words or using correct grammar.

• Semantic variant PPA: People with this variant lose their knowledge of what words mean. They may substitute specific words for unclear terms. Over time, they may struggle with recognizing objects and people.

• Logopenic variant PPA: People with this variant may often pause to find the words they seek. Their speech becomes slower over time. They also have difficulty repeating phrases or words they hear.

Treatment

People who suffer aphasia because of a stroke or brain injury can see dramatic recovery in their language and communication abilities in the first few months after the injury. Once the areas of the brain responsible for language functions are damaged, resulting in aphasia, symptoms usually do not get worse. Speech therapy can help restore some of their lost language abilities, help them use and strengthen their maintained language abilities, and introduce them to other communication modes (e.g., assistive electronic devices).

Even when aphasia results from dementia, speech therapy can help people compensate for their communication difficulties. Although language skills will not improve with treatment, speech therapy focuses on maximizing functional communication for as long as possible, helping patients maintain meaningful relationships with their loved ones.

When to seek emergency medical care

By far, the most common cause of aphasia is stroke. It is important to seek immediate medical attention if you or someone around you suddenly develops trouble with speaking or understanding speech, sudden paralysis or weakness on one side of the body, drooping on one side of the face, confusion, dizziness or problems with balance, or loss of vision.