Aphasia - Loss of speech

The young doctor Helga Weber enjoyed life to the fullest. She loved her job, was a keen track athlete on the side, and loved to travel to faraway countries. When she suddenly fell ill, it seemed unthinkable at first. 

One morning, Helga Weber lost her balance at home and fell over several times. The right side of her body went numb. When she called the emergency services, her voice failed her. She could barely get out a single sound. In the hospital she found out her diagnosis: she has been affected by aphasia as a result of a stroke. 

Helga is not an isolated case. According to the latest WHO data published in 2018 Stroke Deaths in Kenya reached 7,206 or 2.82% of total deaths.  Most Stroke patients experience aphasia at the beginning. The medical term aphasia refers to the complete or partial loss of speech. The disorder occurs after damage to the are of the brain responsible for speech. 

The most common cause of aphasia is stroke. Additional causes are injuries to the skull from an accident, brain tumours, or inflammatory processes in the brain, such as meningitis for example. “Disorders of the language modalities can arise then”, says Dr. Andreas Winnecken from the Josef Bergmann Aphasia Centre in Germany, “particularly for speaking, reading, writing, but also for the processing of speech”. 

There are distinctions made between different degrees of symptoms. “Mild aphasia leads to difficulties with finding the right word, for example, while in moderate aphasia the patient can only speak in one or two-word sentences, and severe aphasia leads to impairment of all linguistic modalities”, explains Winnecken. The latter means that those affected have difficulties expressing themselves verbally and understanding language. 

Aphasia may partially subside because the brain cells surrounding the affected cells (damaged by, for example, a stroke) can take over the speech function. If, and to what extent, aphasia patients recover depends on the magnitude of the brain damage. 

“Because communication is impaired, social alienation is often the consequence”, says Winnecken. For example, it can make it impossible to follow a discussion. And when those affected can no longer read the newspaper or books, they have less intellectual stimulation and fewer discussion topics. “Unfortunately, there are no effective concepts for socially integrating them," Winnecken continues, "and on top of that, there are little to no job prospects". 

“The chance of an aphasia patient returning to full health depends on the degree of the stroke”, says Winnecken. “In general, around 60 percent of aphasics remain chronically ill after half a year”. Aphasia can often bother patients for years or even for a lifetime. This makes extensive treatment even more important, but so too acceptance of the condition. 

In every case, a targeted speech therapy should be integrated into the treatment plan, even in the acute phase. The therapy should make possible the improvement of linguistic functions, the promotion of communication, as well as the active participation in social life. Generally, speech therapy begins in special units for stroke patients with additional treatment continued in a neurological rehab centre, either outpatient or inpatient, says Winnecken. Subsequently, outpatient treatment near one’s home is carried out, coupled with intermittent inpatient therapy.  

Persons with aphasia often have difficulty finding their way back into life because of their illness. “With a brain condition in connection with aphasia there great changes in the social environment often occur”, says Winnecken. Many of those affected withdraw from friends and tensions may arise within the family. 

Misunderstandings and failures in communication efforts lead to frustrations on both sides. "Here it is so important to get professional advice or, with the help of external support, to learn to master these new social situations”, says Winnecken. Support groups can help those affected to learn to solve problems on their own or together with other aphasia sufferers. 

For Helga Weber, the long-term speech therapy was highly successful. After one year of intensive inpatient and outpatient speech therapy the first words returned. Helga kept fighting. She often had doubts but still, she slowly learned with the help of therapeutic support how to make use of the positive energy rooted deep inside of her. 

Today, Helga is making new friends, feels accepted, and approaches others spontaneously, despite problems with finding the right words. She has taken control of her life again and has once again developed a positive outlook on life.