How do you diagnose aphasia

Patients with Wernicke aphasia speak normal words fluently, often including meaningless phonemes, but do not know their meaning or relationships. Auditory and written comprehension is impaired. Patients make errors in reading alexia. Writing is fluent but has many errors and tends to lack substantive words fluent agraphia.

A right visual field cut commonly accompanies Wernicke aphasia because the visual pathway is near the affected area. Patients with Broca aphasia can comprehend and conceptualize relatively well, but their ability to form words is impaired.

However, spoken and written communication makes sense to the patient. Broca aphasia may include impaired prosody and repetition, in addition to anomia.

Writing is impaired. Verbal interaction can typically identify gross aphasias. However, the clinician should try to differentiate aphasias from communication problems that stem from severe dysarthria or from impaired hearing, vision eg, when assessing reading , or motor writing ability. Initially, Wernicke aphasia may be mistaken for delirium Delirium Delirium is an acute, transient, usually reversible, fluctuating disturbance in attention, cognition, and consciousness level.

Causes include almost any disorder or drug. Diagnosis is clinical However, Wernicke aphasia is a pure language disturbance without other features of delirium eg, fluctuating level of consciousness, hallucinations, inattention. Spontaneous speech: Speech is assessed for fluency, number of words spoken, ability to initiate speech, presence of spontaneous errors, word-finding pauses, hesitations, and prosody. Naming: Patients are asked to name objects.

Comprehension: Patients are asked to point to objects named by the clinician, carry out one-step and multistep commands, and answer simple and complex yes-or-no questions. Reading and writing: Patients are asked to write spontaneously and to read aloud.

Reading comprehension, spelling, and writing in response to dictation are assessed. Formal neuropsychologic testing Diagnosis The cerebrum is divided by a longitudinal fissure into 2 hemispheres, each containing 6 discrete lobes: Frontal Parietal Temporal Occipital read more by a neuropsychologist or speech and language therapist may detect finer levels of dysfunction and assist in planning treatment and assessing potential for recovery.

Brain imaging eg, CT, MRI; with or without angiographic protocols is required to characterize the lesion eg, infarct, hemorrhage, mass. Further tests are done to determine the etiology of the lesion eg, stroke evaluation Diagnosis Ischemic stroke is sudden neurologic deficits that result from focal cerebral ischemia associated with permanent brain infarction eg, positive results on diffusion-weighted MRI.

Common causes A seizure typically causes altered Children 8 years often regain language function after severe damage to either hemisphere. After that age, most recovery occurs within the first 3 months, but improvement continues to a variable degree up to a year.

Treatment of certain lesions can be very effective eg, corticosteroids if a mass lesion causes vasogenic edema. The effectiveness of treating aphasia itself is unclear, but most clinicians think that treatment by qualified speech therapists helps and that patients treated soon after onset improve the most. There are several kinds of aphasia. However, the speech may be incoherent, with irrelevant words intruding.

Reading and writing may be difficult. It is hard to access words, and formation of sounds may be difficult. Writing may be affected, but the ability to read and understand often remains intact. Global aphasia : This affects all aspects of language. The person may be able to say a few recognizable, words but they cannot understand speech or read and write. Anomic aphasia : The person may produce grammatically accurate language, but they have difficulty naming objects and words, so they may talk around the word as they try to explain themselves.

Listening and reading may remain intact. The person with aphasia will normally have noticeable difficulty with their use of speech and language. They may become frustrated at their inability to express themselves. Weakness or paralysis on one or both sides of the face or body can also make speech production or writing more difficult.

The muscles used to breathe or swallow can be affected, and this has an impact on the production of sounds. The part of the brain that controls speech and language recognition is referred to as the language center. Aphasia happens when there is damage to any of these parts of the brain or the neural pathways connecting them. Global aphasia happens when there is widespread damage right through the language center, fluent aphasia normally results from damage to the temporal lobe, or the side of brain, and non-fluent aphasia happens when there is damage to the frontal lobe, or the front of the brain.

As many people have aphasia after a stroke, a speech-language pathologist will conduct an evaluation to diagnosis aphasia soon after the event. A comprehensive diagnosis will also include a Computerized Tomography CT or Magnetic Resonance Imaging MRI scan to determine the location and degree of brain damage that has caused the aphasia.

Speech and language therapy is the only treatment for aphasia. Most people do not regain full use of their communication skills, but speech therapy can bring about a significant improvement, even with global aphasia. As there are different levels of aphasia, and not everyone learns in the same way, speech and language therapy techniques will vary.

This is mostly used to treat non-fluent aphasia. It involves the use of humming or singing in rhythm, known as melodic intonation, while repeating phrases and words the patient has been struggling with. This process stimulates brain activity in the right hemisphere. Your doctor may ask:. Mayo Clinic does not endorse companies or products.

Advertising revenue supports our not-for-profit mission. This content does not have an English version. This content does not have an Arabic version. Diagnosis Your doctor will likely give you a physical and a neurological exam, test your strength, feeling and reflexes, and listen to your heart and the vessels in your neck.

Request an Appointment at Mayo Clinic. Share on: Facebook Twitter. Show references Clark DG. Approach to the patient with aphasia.

Accessed Feb. The Merck Manual Professional Edition. Clark DG. Aphasia: Prognosis and treatment. American Speech-Language-Hearing Association. Crosson B, et al. Neuroplasticity and aphasia treatments: New approaches for an old problem. Journal of Neurology, Neurosurgery and Psychiatry.