As many as 25 percent of stroke victims suffer from a serious loss
of speech and language comprehension. The affliction is commonly
known as aphasia, and it is frustrating for patients and caregivers
alike. It is estimated that more than 1 million Americans suffer
from some form of aphasia, which can result from a stroke, brain
tumor, seizure, Alzheimer’s disease or head trauma.
“Aphasia is a very specific condition that deals with disorder
of language,” said Michael Frankel, associate professor of
neurology at the School of Medicine and chief of neurology at Grady
Hospital. “The easiest way to explain it is that a person can’t
express what he wants to say or cannot find the right words, or
that someone else finds it difficult to understand what the person
is saying.
“It all depends, of course, on how much of the brain is damaged,”
Frankel continued. “Damage usually occurs on the left side
of the brain for people who are right-handed. Left-handers are also
more likely to have language function located in the left hemisphere
of the brain, but some have it on the right side of the brain.”
Frankel noted, however, a difference between aphasia and another
disorder known as dysarthria, which is characterized as a problem
of articulation. Both conditions can occur from stroke or in tandem.
A patient with aphasia, for example, may not be able to understand
or express what she wants to say. A person with dysarthria, on the
other hand, understands everything and can express what she wants
to say, but when she tries to use muscles in the mouth and throat
to speak, it becomes difficult to coordinate them correctly, resulting
in slurred speech.
If a stroke is the cause of aphasia, speech therapy can help treat
it, said Frankel, who played an integral role in establishing Operation
Stroke For Atlanta, a multiorganizational group focusing on educating
health professionals as well as the community about stroke.
Some aphasia patients, however, do not undergo speech therapy but
nevertheless show signs of improvement. Frankel said it is important
to recognize aphasia as a symptom of stroke since difficulty speaking
can often be a warning sign. A person can exhibit signs of aphasia
prior to suffering a stroke.
“If a person has five minutes of difficulty speaking where
the words don’t come out, or they come out mixed up, that may
be a warning sign of a stroke—even if it lasts just a few minutes,”
Frankel said.
The warning signs of stroke also include sudden weakness on one
side of the body or sudden numbness. This is often a sign of a transient
ischemic attack, signifying that something is wrong with the blood
vessels in the brain. At this stage it is often possible to introduce
treatment to intervene and prevent another stroke from occurring.
A stroke occurs when part of the brain is deprived of oxygen and
affected nerve cells die. The brain cells that are killed cannot
operate. The result is weakness, paralysis, or difficulty speaking,
like aphasia.
There is no known cure for aphasia. According to the National Aphasia
Association, 66 percent of aphasia cases result from stroke. Some
patients are fortunate to recover completely within the first few
hours or days. This is known as transient aphasia.
If aphasia symptoms persist beyond the first two to three months
after a stroke, a complete recovery is unlikely. Recovery is a slow
process that usually requires a minimum of a year of treatment including
helping the individual and family understand and adjust to long-term
deficits.
Earlier this year, Frankel was appointed vice president of the
southeastern affiliate of the American Heart Association. During
his three-year term in office, Frankel will help orchestrate the
activities of the American Heart Association and the American Stroke
Association in their mission to fight heart disease and stroke.
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