MAINTENANCE – Professor Yannick Béjot, neurologist, takes care of patients with this spoken, written and read language disorder. It describes the two main forms of aphasia.
After the announcement by his relatives that Bruce Willis was ending his career due to aphasia, Professor Yannick Béjot, head of the neurology department at the Dijon University Hospital, explains this little-known language disorder which affects more than 300,000 French people .
LE FIGARO.- In what does this disease consist?
Pr Yannick BEJOT.- It is not a pathology but a symptom. It is a loss of spoken, read and written language, which can be more or less complete. Some patients have an inability to express themselves both orally and in writing, even though they understand what is being said to them. It is very frustrating. This disorder can go as far as mutism. Other patients have a comprehension disorder. They have the impression that someone is speaking to them in Chinese, or another foreign language, and do not realize that they are aphasic. They themselves, when they speak, use jargon, invented, distorted or misused words, and meaningless phrases. Their rehabilitation is difficult because these patients generally take time to understand that they have a language deficit. But most of the time, these two forms of aphasia (expression and comprehension) are intertwined because the lesion is located in two areas of the brain.
What causes aphasia?
There are two main types of aphasia. On the one hand, progressive aphasia which sets in insidiously and worsens over time. They are mainly due to neurocognitive diseases, such as Alzheimer’s. Other symptoms are frequently observed, such as memory problems, but they may set in later. The other type of aphasia occurs suddenly, following a cerebrovascular accident (CVA) or an accidental head trauma. The other associated signs are paralysis, sensitivity or visual field disorders. Even if we do not know the origin of Bruce Willis’ aphasia, we can imagine that it is rather progressive, since no sudden cause has been mentioned by his family.
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Are these symptoms reversible?
It all depends on the cause. In the event of stroke or trauma, the sequelae can improve and even disappear, thanks to treatment. Progress then takes place mainly in the first six months, then up to two years, after the accident. Young patients, who have better brain plasticity, are more likely to recover. In case of neurocognitive disease, the objective will be to slow down the decline, to avoid aggravation of aphasia and associated signs by stimulation of the damaged areas.
What does support consist of?
In all cases, it is based on speech therapy which is available according to the specific disorders of the patient. These are exercises based on communication: repetition of words, construction of sentences, understanding of small scenarios, work on semantic fields… The program, which takes place at the rate of one to three sessions per week , is regularly reassessed by the speech therapist. It can be arranged according to the patient’s tolerance.
How can families be supported?
It is very important for relatives to be able to discuss with the doctor in charge of the patient, often the neurologist, or with the speech therapist, to fully understand what aphasia is. It is indeed a difficult disorder to understand, and families sometimes have the impression that the patient does not make an effort to understand. Unfortunately, aphasia remains relatively unknown and little publicized. We often show a character victim of a heart attack in the cinema, never of a stroke (while the latter is more frequent than the first). It’s a shame because emergency care is essential to limit the after-effects. Any sudden loss of language should be considered an alert.