Aphasia

Definition

Aphasia is an acquired language disorder caused by damage to dominant-hemisphere (usually left) cortical language areas. It affects spoken language, comprehension, reading, and writing but not intelligence.

Major Types

• Expressive (Broca) aphasia: Damage to Broca's area, such as halting, effortful speech with preserved comprehension. Patient knows what to say but cannot produce it.
• Receptive (Wernicke) aphasia: Damage to Wernicke's area. Fluent but nonsensical speech ('word salad') with impaired comprehension.
• Global aphasia: Severe impairment of all language functions.
• Anomic aphasia: Word-finding difficulty only.

Common Causes

Ischemic or hemorrhagic stroke, traumatic brain injury, brain tumor, and neurodegenerative disease (primary progressive aphasia).

Nursing Interventions

Use short, simple sentences and yes/no questions for receptive aphasia; allow ample time and avoid finishing sentences for expressive aphasia. Use communication boards, gestures, writing, or electronic devices. Refer early to speech-language pathology.

NCLEX Relevance

Must differentiate Broca (can't speak) from Wernicke (can't understand) on case studies. Expect therapeutic communication questions adapting to each type.