Related Disorders

The following related disorders may cause or accompany aphasia. Additionally, aphasia is sometimes confused with other disorders.

There are many causes for aphasia including stroke, brain trauma, brain tumours, and progressive neurological disease. Moreover, there are a variety of disorders of communication that may be due to paralysis, weakness, or incoordination of the speech musculature or to cognitive impairment. Such impairment may accompany aphasia or occur independently and be confused with aphasia.

It is important to distinguish these related disorders from aphasia because the treatment(s) and prognosis of each disorder are different.

Apraxia

A collective term used to describe impairment in carrying out purposeful movements. People with severe aphasia are usually extremely limited in explaining themselves by pantomime or gesture, except for expressions of emotion. Commonly they will show you something in their wallet, or lead you to show you something, but this is the extent of their non-verbal communication.

Specific examination usually shows that they are unable to perform common expressive gestures on request, such as waving good-bye, beckoning, or saluting, or to pantomime drinking, brushing teeth, etc. (limb apraxia). Apraxia may also primarily affect oral, non-speech movements, like pretending to cough or blow out a candle (facial apraxia).

This disorder may even extend to the inability to manipulate real objects. More often, however, apraxia is not very apparent unless one asks the patient to perform or imitate a pretended action. For this reason it is almost never presented as a complaint by the patient or the family. Nevertheless it may underlie the very limited ability of people with aphasia to compensate for the speech impairment by using informative gestures.

Apraxia of Speech

Frequently used by speech pathologists to designate an impairment in the voluntary production of articulation and prosody (the rhythm and timing) of speech. Highly inconsistent errors characterizes apraxia.

Brain Trauma

Aphasia can be the result of a brain injury and may accompany damage after head trauma. This common complication may present differently for each individual. People with aphasia after a head injury often see improvement as the brain heals, and speech-language therapy treats lingering aphasia.

Dysarthria

Refers to a group of speech disorders resulting from weakness, slowness, or incoordination of the speech mechanism due to damage to any of a variety of points in the nervous system. Dysarthria may involve disorders to some or all of the basic speech processes: respiration phonation, resonance, articulation, and prosody. Dysarthria is a disorder of speech production not language (e.g., use of vocabulary and/or grammar). Unlike apraxia of speech, the speech errors that occur in dysarthria are highly consistent.

Dysphagia

Refers to those who have difficulty swallowing and may experience pain while swallowing. Some people may be completely unable to swallow or may have trouble swallowing liquids, foods, or saliva. Eating then becomes a challenge. Often, dysphagia makes it difficult to take in enough calories and fluids to nourish the body. (Definition from National Institute of Deafness & Other Communication Disorders – www.nidcd.nih.gov)

Dementia

A condition of impairment of memory, intellect, personality, and insight resulting from brain injury or disease. Some forms of dementia are progressive, such as Alzheimer’s disease, Picks disease, or some forms of Parkinson’s disease. Language impairments are more or less prominent in different forms of dementia, but these are usually overshadowed by more widespread intellectual loss. Since dementia is so often a progressive disorder, the prognosis is quite different from aphasia.

Stroke

Stroke is the number one cause for aphasia, and 25% – 40% of stroke survivors develop aphasia. Just as hearts can experience a “heart attack,” brains can experience a “brain attack” when problems with blood flow to a section of the brain occurs. Bleeding in the left side of the brain can cause aphasia as the blood affects language centers in the brain. Luckily, the brain can sometimes form new channels of communication after sustaining damage in a section, and speech-language therapy can help patients regain communication skills.

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