Broca’s and Wernicke’s Aphasia

Let's start at the beginning.

Aphasia is the inability to express thought in speech. This is due to injury to the brain centres that govern this activity. This is by cutting of blood supply to these centres due to blood vessel rupture causing haemorrhage to the brain tissue, blood vessel blockage by an embolus or formation of a clot on the diseased vessel wall. Conditions such as tumors can be the cause.

The factor of importance is the interference of the definite areas of the brain that control this activity. Hence, it can be a symptom of apoplectic seizure or it can occur by itself, the difference being in the extent of the brain involved. There are different types of aphasia, but for now I’ll focus on Broca’s and Wernicke's aphasia.

Broca's aphasia, previously referred to as efferent motor, verbal or motor aphasia, is a common non-fluent aphasia. It is caused by a lesion that affects the Broca's area. This is the term referring to the left frontal lobe's third frontal convolution. This is inclusive of both the sulcus and gyrus and makes up the pre-motor's cortex lower part. The damage caused by this lesion extends into the white matter and occasionally extends to the posterior to the motor strip.

The conditions symptoms are inclusive of telegraphic speech short sentence length. If the case is extreme, the patient might only have utterances of single words, which are mostly nouns. Labored and slow speech is witnessed in the cases with the morphology and syntax of words being affected with production of only the over learned and most basic grammatical forms. In these cases, word finding and the agility of articulation is impaired. This is together with distortion of consonants and the melodic contour being flat.

Understanding Patients with Broca's Aphasia

Those with this condition are fully aware of the errors they make. Hence, their frustration rate is low and they respond to the errors by actions such as weeping. Responses and support we give to them in their condition should therefore be as human and empathetic as possible. This is my constant aim.

Wernicke's aphasia is also referred to as receptive, fluent or sensory aphasia. Its cause is neurological damage to the Wernicke’s area of the brain. This is the Brodmann Area 22 located in the superior temporal gyrus' posterior in the dominant hemisphere. It is different from the former case as though the language content is not correct the speech is preserved. This due to insertion of non-existent or incorrect words into the sentences, or the overuse of jargon. Some words replace by others thus forming poor to comprehend statements.

In my encounter with patients who have recovered from this condition, they have stated that whilst they were still in it, they found the utterances of others unintelligible. Moreover, although they knew that they were speaking, they found it difficult to stop themselves and they could not comprehend what they themselves said. We should thus be patient with them and offer our full emotional and psychological support.