Dysphasia: Symptoms, Causes, Diagnosis & Treatments
What is dysphasia? A breakdown of the symptoms associated with this disorder, how it develops, diagnosis and treatments.
7 minute readDysphasia is a common disorder that affects over 350,000 people in the UK. However, many people have never heard of the condition, or know little about it. In this article, we'll take a look at what dysphasia is, what causes dysphasia, what symptoms to look out for, and what treatments are available.
What is dysphasia?
Dysphasia is a disorder that affects your ability to speak or understand language. It can also cause problems with other forms of communication, such as reading, writing and non-verbal gestures (body language). It is sometimes known as aphasia, though aphasia is medically defined as a complete inability to speak.
Dysphasia is not a disease in itself, but a symptom that occurs when parts of the brain are damaged because of an illness or injury.
There are three main types of dysphasia:
Expressive dysphasia
Receptive dysphasia
Global dysphasia
Expressive dysphasia
Expressive dysphasia is difficulty using speech. People with expressive dysphasia have trouble forming words and sentences, though they normally understand what is being said to them. Most people with expressive dysphasia are aware of their speech problems.
Receptive dysphasia
Receptive dysphasia is difficulty understanding what other people say. People with receptive dysphasia normally speak fluently, but their speech doesn't make sense. They are usually unaware that others can't understand them.
Global dysphasia
People with global dysphasia have extreme difficulty with both expressing and understanding speech.
Types of expressive & receptive dysphasia
There are a number of variations of expressive dysphasia and receptive dysphasia.
Broca's dysphasia
This is a common type of expressive dysphasia where there is damage to the Broca's area in the brain.
The Broca's area controls the muscles you use to speak and people with Broca's dysphasia find it difficult to form words and sentences. They often take long pauses between words and speak in short sentences. In severe cases, they may not speak at all.
People with this form of dysphasia have no problem understanding what other people say.
Transcortical dysphasia
This is a less common type of dysphasia that affects the nerve fibres that allow communication between different parts of the brain. Transcortical dysphasia can be expressive, receptive, or a combination of both.
There are 3 types of transcortical dysphasia:
Transcortical sensory dysphasia — people with this type of receptive dysphasia can speak without difficulty but are unable to understand what others say. They can typically repeat words and sentences, but do not understand what those words and sentences mean.
Transcortical motor dysphasia — this type of expressive dysphasia is similar to Broca's dysphasia and causes problems producing speech. Unlike Broca's dysphasia, people with transcortical motor dysphasia are able to repeat words and sentences.
Mixed transcortical dysphasia — this type of dysphasia affects both speech and understanding. People with mixed transcortical dysphasia can usually repeat what others say and may be able to sing familiar songs.
Wernicke's dysphasia
Wernicke's dysphasia is a type of receptive dysphasia caused by damage to the Wernicke's area of the brain (the part of the brain that helps us to understand language). People with Wernicke's dysphasia have no problems speaking, but what they say does not make sense and their speech may be difficult to understand. They may also have difficulty understanding others.
Anomic dysphasia
This is a mild form of expressive dysphasia where people have trouble remembering common words or names for things. When they can't find the right word, they may use a vague, or more general term, try to describe the word, or use gestures to explain what they mean.
Conduction dysphasia
Conduction dysphasia is one of the rarest types of expressive dysphasia and affects the ability to repeat words and phrases. People with conduction dysphasia can understand and speak fluently.
What causes dysphasia?
Dysphasia is caused by damage to the parts of the brain responsible for understanding or forming language. This can be due to injury or disease. Some causes result in permanent dysphasia, while in other cases such as transient ischaemic attacks, seizures or migraines, the dysphasia is usually temporary and resolves once the attack is over.
Common causes of dysphasia include:
Degenerative diseases such as multiple sclerosis, Parkinson’s disease, and Alzheimer’s disease
Traumatic brain injury
Brain surgery
Brain tumours
Brain damage from lack of oxygen (cerebral hypoxia)
Transient ischaemic attack (TIA)
Encephalitis (inflammation of the brain)
Seizures (fits)
Congenital disorders (a disorder that you are born with)
Radiotherapy or chemotherapy
Toxins or poisoning, such as carbon monoxide or heavy metal poisoning
What are the symptoms of dysphasia?
The symptoms of dysphasia vary from person to person and depend on the area of the brain that has been damaged, and how severe the damage is.
Symptoms of expressive dysphasia may include:
Forgetting or struggling to remember common words
Using the wrong, but related word (for example "fork" instead of "knife")
Speaking slowly
Difficulty forming words
Using short words or sentences
Making mistakes with grammar or not using grammar at all
Using words in the wrong order
Missing out short words like "to," "of" or "the" (telegraphic speech)
Speaking fluently, but without meaning
Using nonsense words
Symptoms of receptive dysphasia may include:
Difficulty understanding speech, particularly fast speech, or complex grammar
Giving the wrong answers to simple questions
Taking a long time to understand speech
Not being aware of mistakes in speech
Misinterpreting meaning
People with global dysphasia may show symptoms of both expressive and receptive dysphasia.
Other difficulties associated with dysphasia
Dysphasia may also cause difficulty with:
Reading
Writing
Telling the time
Dealing with money
Using numbers
What should I do if I have symptoms of dysphasia?
Depending on the cause, dysphasia symptoms can start suddenly, or appear gradually and get worse. Early signs of dysphasia may include struggling to find the right word, speaking slowly, and using short sentences.
If you or a loved one shows signs of dysphasia, it’s important to see a doctor as soon as possible. Dysphasia is usually a sign of another medical condition, such as a stroke, which needs immediate treatment.
Early diagnosis of dysphasia also allows you to start treatment early, which improves your chance of recovery.
How is dysphasia diagnosed?
Dysphasia is diagnosed in a variety of ways, including:
Physical examination — your doctor will examine you and perform a neurological examination to test your mental status, motor skills, balance, and sensory nerves.
Imaging tests — these may include a CT scan or MRI to check for the underlying cause of your dysphasia.
Speech evaluation — your doctor or speech therapist will assess your speech and level of understanding.
How is dysphasia treated?
Here are the various ways in which dysphasia could be treated.
No treatment
Sometimes, mild dysphasia can resolve without treatment.
Speech and language therapy (SLT)
Speech and language therapy focuses on trying to regain as much language as possible and teaching alternative forms of communication. It can be group therapy, or one-on-one therapy, and is tailored to your individual needs.
Constraint-induced aphasia therapy (CIAT)
This is a short term, intensive language therapy used to treat people with dysphasia caused by a stroke or other neurological condition. It usually involves 30 hours over 2 weeks and focuses on practising and shaping speech, and stopping the use of alternative methods of communication, such as writing, gesturing, or pointing.
Medication
There has been some research into medications such as piracetam to treat dysphasia following stroke, but the results were inconclusive and further studies are needed.
Are there any current or scheduled trials for the treatment of dysphasia?
Currently, there are no ongoing or scheduled trials on new treatments for dysphasia.
Can dysphasia be cured?
There is currently no cure for dysphasia. Treatment is most effective when started as soon as possible after symptoms appear.
Patients with dysphasia caused by a single event such as a stroke or traumatic brain injury normally recover better with treatment than those with a degenerative condition, like Alzheimer’s disease.
Dysphasia is a challenging condition that makes it difficult to communicate with others and may lead to isolation, anxiety, and depression. However, with early treatment and support, many people with dysphasia are able to improve their symptoms, learn skills to manage their condition and lead healthy, fulfilling lives.
