Defined as impairment of speaking, listening, reading, and/or writing secondary to brain insult. Broca’s, Wernicke’s, and global aphasias are the most common. Many cases do not fit all the features of the classic syndrome descriptions. It is important to assess patients for agnosia, a complex sensory and recognition disorder that can often be misdiagnosed as aphasia. The cortical aphasias (listed below) usually involve the dominant hemisphere and will have anomia. Anomic aphasia (temporal-parietal area and angular gyrus) is characterized by poor naming skills. Subcortical aphasias can involve the internal capsule and putamen and are characterized by sparse output and impaired articulation.

Cortical aphasias:

Treatment of aphasia is individualized to take advantage of residual/recovering function and compensate for deficits, which can vary considerably, even for patients with the same aphasia syndrome. Melodic intonation therapy (thought to utilize “musical” areas in the nondominant hemisphere) may be helpful for patients with expressive aphasia. It has been shown that intensive therapy, on average of 98 hours postinsult, provides positive outcomes.¹ Family members should be trained to encourage participation of the aphasic patient in conversation and to allow plenty of time for the patient to regain expression.