Aphasia in Multiple Sclerosis: What You Should Know

Yes, It's Rare. But When It Happens, You Can Help.

Man In Speech Therapy. Credit: BSIP / Contributor / Getty Images

Generally speaking, aphasia is partial or total loss of words, resulting in problems communicating with others. People with aphasia may have:

  • Inability to speak clearly and/or to understand what other people say
  • Inability to write clearly and/or understand written words

If that sounds to you like a really distressing condition, you’re right. Imagine the emotional pain of not being able to fully connect with family members, friends, and others in conversation or in writing.

In fact, in a clinical study asking almost 70,000 patients with 60 diseases about how greatly 15 health-related factors affected their quality of life, aphasia was found to have the greatest impact of all. That included having a greater negative impact on quality of life than either cancer or Alzheimer’s disease.

Doctors classify aphasia into three types:

  • Problems using words and sentences (expressive aphasia)
  • Problems understanding others (receptive aphasia)
  • Problems with both using words and understanding (global aphasia)

It’s important to know that having aphasia doesn't affect a person’s intelligence.

How Common Is Aphasia in MS?

Until recently, aphasia wasn’t thought to be a symptom of multiple sclerosis (MS). That was because MS mainly involves the white matter of the brain and spinal cord. In contrast, aphasia occurs most often in people with diseases involving the gray matter that damage the cerebral cortex, the part of the brain responsible for language.

That said, true aphasia is an uncommon MS symptom. In addition, aphasia should be differentiated from problems affecting the voice (ability to produce speech) in people with MS, such as dysarthria or dysphonia.

What’s Aphasia Like in People With MS?

Although aphasia in MS is considered rare, a recent clinical study showed that almost 40% of participants with MS had at least some degree of reduced word-finding abilities.

Most commonly, people with MS experience aphasia over the course of their disease as problems recalling the names of people, places, and things or the way to spell words. (This is most often classified as dysphasia, which is less severe than aphasia.) They may also experience sudden acute aphasia during an MS relapse, or flare-up.

Can Aphasia Be Treated?

There’s no cure for aphasia. Speech and language therapy may help restore at least some ability to communicate. However, aphasia affects different people differently, and the outcome of therapy can’t be predicted.

Tips for Speaking With a Person Who Has Aphasia

Here are some ways you can help a person with aphasia feel more comfortable speaking:

  • Keep your sentences simple – and short.
  • Don’t ask questions that call for complicated answers.
  • Don’t “change the subject” abruptly.
  • Keep background noise to a minimum.
  • Be patient: Give the person plenty of time to respond to what you’ve said.
  • Don’t correct the person’s grammar or usage.
  • Keep in mind that difficulty speaking can affect tone of voice as well as word selection. The person’s tone may not always reflect his or her mood.
  • Have some paper and a pen or pencil handy.

Another way you can help is to suggest tips for helping to keep words in memory so the person can “find” them more easily. For example, help him or her focus on:

  • The first letters of important words
  • “Cues” to remembering words, such as the categories of things that include them – for example, connecting the word “cooking” with “kitchen things”

Sources:

Barrera MA. “When words won’t come easily: understanding and improving MS speech and communication symptoms.” Multiple Sclerosis Foundation (2012).

Oger J, Al-Araji A, Cabrera-Gomez JA, et al. (Eds). “Multiple sclerosis for the practicing neurologist.” Demos Medical Publishing (2007).

“Aphasia fact sheet.” National Aphasia Association (2016).

Paddock M. “What is aphasia? What causes aphasia?” Medical News Today (2014).

Kirschner H, Chawla J. “Aphasia.” Medscape.com (2016).

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