Aphasia: definition

The term "aphasia" includes a heterogeneous and multiform group of language deficits, usually consequent to cerebral pathologies: in general, aphasia identifies an alteration of the ability to understand and use both words and verbal expressions. In other words, aphasic patients are not able to transform their thoughts into words. An aphasic should not be considered a fool or a dementia: the lesions caused by aphasia do not alter the intelligence of the patients, nor the ability to feel sensations and feelings.

Aphasia: incidence

Unfortunately, aphasia is a fairly common disorder in our country: medical statistics, in fact, report about 150, 000 patients with aphasia in Italy. Aphasia can be considered a disorder of senile age, as it is rare in children and adults: it affects 40% of patients with a left hemisphere stroke, a cerebral locus including the cortical centers of speech (in 95% of subjects right-handed and 60% of left-handed people) [from www.msd-italia.it].

What worries Healthcare is the fact that aphasic patients seem to increase from year to year: in fact, annually, around 20, 000 new cases occur.

Meaning of the term

The term aphasia derives from the Greek α'φασία, which means mutism : although the literal translation indicates the total incapacity of elocution, aphasia is not synonymous with mutism proper, let alone of dysarthria (impossibility of articulating words). More precisely, an aphasic patient is not always defined as "one who does not speak", but as "one who speaks, without the ability to communicate". From the syntactic and semantic point of view, the language of aphasics is meaningless.

General description

"Aphasia" is an often simplistic term, used to identify the diseases of the language and all the associated disorders: in fact, aphasia not only affects the production of words, but also the structuring of the same, the understanding of language and the repetition of words. The disease affects multiple aspects of communication, depending on the areas of the brain affected and the severity of the disorder. Again, aphasia can only affect the ability to repeat a word or phrase, to express a concept, to speak or to write.

Aphasia: causes

Aphasia can be the result of stroke, head injury, multiple sclerosis and Alzheimer's disease; more generally, any cerebral deficit can generate aphasia when it involves the encephalic structures used for word processing (generally, the Wernicke area and the Broca area) or in any case the dominant hemisphere.

The most involved brain areas mostly concern the left hemisphere for right-handed individuals; when aphasia affects the right hemisphere, one speaks correctly of afasiacrociata (rare case).

In the vast majority of cases, the cause of aphasia lies in a vascular lesion: more precisely, one speaks of cerebropathy. When a cerebral artery breaks or becomes blocked, it triggers a chain of events: the blood diffuses into the brain causing hemorrhage or ischemia, or in other cases a stroke (cerebral apoplexy or stroke). Other possible causes of aphasia include: transient ischemia (aphasia regresses in a few hours / days), cerebral infarcts, encephalitis and infectious processes, partial epileptic seizures (aphasia disappears in a few minutes), attacks of migraine headache . Aphasia has also been diagnosed in some patients with brain tumors (rare case).

Associated diseases

Aphasia is rarely the only symptom of a pathology: in fact, more frequently, lesions of the brain (near the areas of language regulation) are also transmitted to adjacent brain loci, thus affecting other functions.

Strictly speaking, aphasic patients tend to present other disorders, such as:

  • Dysarthria: inability or difficulty to articulate words.
  • Apraxia: inability to control movement in order to perform an action, even as simple as eating or writing. Apraxia expresses a neurological deficit in voluntary musculature.
  • Hemiplagia: mid-body paralysis.
  • Hemiparesis: partial loss of movement capacity.
  • Amnesia: it should not seem strange that many patients with aphasia also suffer from memory loss, given that most memories are imprinted in the mind thanks to the word. However, in similar situations, it seems that ataxic and amnesic patients tend to remember that given event after help from those around them: in general, memory loss is not permanent.
  • Hemianopsia: vision is partially denied. Hemianopsic patients are not able to see what lies beyond their right half of the space.
  • Epileptic attacks sometimes associated with loss of consciousness.
  • Movement alteration: irritability, apathy, lack of control of actions.

However, every person with aphasia responds differently and subjectively to the disease: the clinical picture that results from it, in fact, is unique, since the symptoms that accompany the disorder vary from subject to subject.

Aphasia: associations

The aphasic subjects can contact the ALIAS association, born in Italy around 1996: they are a voluntary organization, aimed at informing, raising awareness and involving the population. The objective of ALIAS is to seek an alternative program aimed at facilitating the communication of aphasic patients and, at the same time, finding an alternative therapy, stimulating medical research.

Another federation, the A.IT.A - an acronym for Italian Aphasic Associations - is made up of aphasic patients, family members, volunteers and neurologist specialists, speech therapists and therapists; it is financed both by private and public bodies, and by members belonging to the organization.

The A.IT.A has the objectives of encouraging research, informing the population, planning conferences and seminars, encouraging contact between the patient and the family member, stipulating associations and promoting assistance and volunteering for those affected by aphasia. [taken from www.aitafederazione.it]