Global aphasia is a form of aphasia, a language communication disorder, where a patient has trouble understanding and generating language. This is the most severe form of aphasia, and it can be a significant impairment for the patient. Usually the cause is a stroke in the middle cerebral artery that causes death of brain cells. Patients can benefit from speech-language therapy and augmentative communication, where a therapist works with the patient to facilitate communication without the use of language.
In patients with global aphasia, lesions are present in two language-associated areas of the brain, Broca's area and Wernicke's area. The damage to the brain makes it difficult for the patient to understand written and spoken language. He also has trouble writing or speaking. Patients with this condition may repeat words or phrases or get stuck on single letters. They may also not understand the words they are generating; some may repeat epithets, for example, without being aware that the words they are using may offend other people.
Other cognitive functions may be normal, reflecting the isolated nature of the damage. Some patients may have other neurological impairments as a result of widespread brain damage, in which case they could need physical therapy or other forms of assistance. Global aphasia is often frustrating for patients because their cognitive abilities are intact, but they have difficulty communicating with the people around them. Lack of language skills can lead to situations where people yell or talk slowly to a patient, thinking this will resolve the problem, and this can be frightening as well as irritating.
Communication options for a patient with global aphasia vary, depending on the nature of other impairments. Some patients find a communication board with visual representations helpful; the patient can point at the board to express hunger, for example, or string images together to convey a more complex thought. Personal assistants and aides may work with the patient on expressing ideas that are difficult to convey with the use of a communication board.
Patients diagnosed with global aphasia should receive a thorough evaluation from a neurologist and a speech-language pathologist to determine the extent of the damage to the brain and develop an appropriate treatment plan. Every patient is different, and damage to the brain is highly variable, making it important to customize treatment plans and to confirm a diagnosis; for example, a patient may be mute from psychological distress, rather than unable to communicate verbally.
