Wernicke’s aphasia is a severe speech and word-finding disorder. Sufferers suffer from extreme language impairment and are only able to understand or reproduce the simplest words with great difficulty. Wernicke’s aphasics are only able to understand speech content at all with intensive training and therapy by focusing on facial expressions and speech differences.
What is Wernicke’s aphasia?
Wernicke’s aphasia is one of the most profound language disorders that can afflict people. Ironically, aphasia occurs only after language development is complete. Affected individuals may have some vocabulary, but are unable to express themselves in a concrete and focused manner. Therefore, it is possible that Wernicke’s aphasia interferes with language development completely or only partially. Aphasics are nevertheless able to recognize facial expressions and to interpret the volume and intention of the tone of voice, for example when an angry person is shouting or someone is crying. The disease must be strictly distinguished from a mental or intellectual disability.
Causes
The cause of this form of aphasia is usually sustained damage to the Wernicke speech center, a brain region in the upper temporal lobe of the affected person. In most cases, this is caused by a stroke or, less commonly, an accident. In these circumstances, the speech center is either directly damaged or not supplied with sufficient blood and suffers lasting damage as a result of the acute lack of oxygen. In accidents, craniocerebral trauma, which can occur in sports or road traffic accidents, not infrequently directly injures the affected area of the brain, causing it to suffer permanent damage. The rarer causes of Wernicke’s aphasia may include a localized brain tumor, deficiencies in the brain, or age-related dementia.
Symptoms, complaints, and signs
Aphasias can affect all areas of human communication. This includes speech interpretation, language, and reading and writing. If the aphasia was caused as a result of direct damage to the brain area, the disorder in question occurs directly and almost without delay. Aphasias that have their origin in dementia occur insidiously in episodes and progress continuously in the course of degenerating brain substance. Dementia-related loss of brain matter associated with aphasia is often accompanied by secondary symptoms such as changes in personality and person-related habits, as well as memory and concentration problems. Wernicke’s aphasia results in two basic symptoms. On the one hand, Wernicke’s aphasics suffer from word-finding disorders in which words are strongly modified in their structure and thus meaning. Thus, syllables and letters are omitted or added depending on the person. For example, a simple word like ball becomes all. As a result of this symptomatology, called paraphasia, the aphasic may also completely confuse word meanings. This can happen even with words that do not have a similar sound. On the other hand, not only single word formation is affected, but the whole grammatical competence. Sentences formed by Wernicke’s aphasics often appear long and cryptic, subordinate clauses are incorrectly connected or duplications occur, making the complete sentence formation incomprehensible.
Diagnosis and course of the disease
Because language plays a central role in our lives, detecting and diagnosing aphasia is relatively straightforward. When the first symptoms such as those already mentioned occur, the affected person is tested for Wernicke’s aphasia by a neurologist on the basis of appropriate tests. So-called token tests have proven to be particularly effective. The neurologist asks the patient to arrange several cards of different colors and sizes in pairs to match each other. This first test determines in most cases whether an aphasic speech disorder is present. An even more precise determination of a speech disorder can only be made with the AAT test (Aachen Aphasia Test). This test can also determine the degree of the disorder and also serves as a long-term tool in therapy to determine whether therapeutic countermeasures are effective.If these tests are ordered as a result of direct damage to the brain, neurologic tests that address the patient’s intelligence and personality should also be performed.
Complications
As a rule, those affected by Wernicke’s aphasia suffer from a very pronounced speech disorder. In this case, those find it difficult to find the simplest words, so that the affected person finds it very difficult to communicate with other people. The disorder has a very negative effect on the patient’s everyday life and can lead to severe social discomfort and complications. The development of children is also significantly restricted due to Wernicke’s aphasia, so that various complaints can also occur in adulthood. Often, children also suffer from concentration disorders or memory problems. Various words are also confused, so that those affected sometimes suffer from panic attacks because they are ashamed of the disorder. Especially in children, this can lead to bullying or teasing, causing them to suffer from depression or other psychological disorders. A direct and causal therapy for Wernicke’s aphasia is usually not possible. Those affected are dependent on various therapies that can alleviate the symptoms. However, a positive course of the disease cannot always be predicted. However, the patient’s life expectancy remains unaffected by Wernicke’s aphasia.
When should you see a doctor?
Interpersonal communication disorders should always be discussed with a physician. If language can be learned by children only with difficulty or not at all, contact with a doctor should already be established. Adults, adolescents or children who have already learned to speak sufficiently also need medical help and support if their speech regresses. Clarification of the cause is necessary so that a diagnosis can be made and a treatment plan established. If there are problems with word finding or if the articulation is characterized by irregularities, the affected person should see a doctor. Inconsistencies in memory, confused speech and a reduced ability to concentrate should also be examined and clarified. If adults show unusual changes in personality, behavioral disturbances or a decline in memory, a doctor should be consulted. If the affected person regularly confuses words with each other, this should be understood as a warning signal from the organism. If subordinate clauses can no longer be correctly linked, this is to be interpreted as a further sign of a present illness. If sentence formations are completely incomprehensible to people in the immediate environment, this circumstance should be discussed with the affected person. He needs medical help, as this is a disease for which therapy is necessary.
Treatment and therapy
After appropriate diagnosis and determination of the severity of aphasia, linguistic therapy supported by neurologists and speech therapists can be provided. The earlier Wernicke’s aphasia is detected, the greater the patient’s chances of regaining communication. The primary goal of therapy is to renew the ability to speak. In addition, the therapist must be able to convey the feeling that the patient is not alone with his drastic illness, but that there are definitely positive chances of recovery in sight. To regain basic language skills, the therapist will use familiar, simple word sequences. Reciting the months, favorite objects, days of the week or family names are just the first step and quickly show success, which should further motivate the patient. Since Wernicke’s aphasia often affects the formation of sentences, the therapist uses the simplest sentences to practice correct grammar and meaningful word order. Towards the end of therapy, the aphasic person is finally trained to apply the regained language skills to everyday communication. This section is usually done in the controlled environment of group therapy with other aphasics and takes away the patient’s fear of having to speak in front of strangers in an unfamiliar situation.
Prevention
Preventing Wernicke’s aphasia completely is simply impossible. However, except for accidents due to acts of God, it is possible to prevent risk factors such as strokes or sclerosis.Eating a healthy, balanced diet, exercising and staying mentally active mean a huge reduction in risk. Pay attention to key nutritional values such as blood sugar levels, your cholesterol levels, blood lipid levels and your blood pressure. Avoid regular smoking and work on possible obesity.
Follow-up
In most cases, direct follow-up measures for Wernicke’s aphasia are significantly limited and, in some cases, not even available to the affected person. Therefore, ideally, the affected individual should seek medical attention at the first signs of this condition and also seek treatment to prevent the occurrence of further symptoms and complications. Self-cure usually cannot occur in Wernicke’s aphasia, so treatment by a doctor is necessary. As a rule, the person affected by this disease is dependent on the measures of physiotherapy and physiotherapy. In this case, many of the exercises can also be repeated at home, which significantly accelerates the healing process. As a rule, the intake of various medications is also very important. It is important to ensure that the medication is taken regularly and in the correct dosage in order to counteract the symptoms in the long term. In case of questions or side effects, a doctor should always be consulted first. The further course of Wernicke’s aphasia is strongly dependent on the severity of the disease, so that a general prediction cannot be made. Under certain circumstances, the life expectancy of the affected person is also reduced.
What you can do yourself
Wernicke’s aphasia primarily requires medical treatment. The mostly causative stroke must be clarified before therapy can be started. Which supportive measures are useful depends on the individual symptom picture. Comprehensive speech and swallowing therapy is almost always necessary. Therapy can be supported at home by regular speech and the performance of appropriate exercises. The patient needs a lot of support and attention during this phase of the disease. The stroke usually also leads to immobility, which can be compensated for, for example, by organizing an outpatient nursing service. In addition, it should be ensured that the patient takes the prescribed medication exactly as prescribed by the doctor. Preventing a recurrence of stroke also involves identifying risk factors. In general, a healthy lifestyle must be maintained with adequate exercise, low stress and a healthy diet. The affected person should always be informed about incorrectly formed sentences or words. Regular training is the most important measure to restore the lost abilities. Which self-help measures are useful in detail must be discussed together with the responsible physician.
