Wernicke’s aphasia

Wernicke’s aphasia is a condition caused by an injury to the brain, such as after a stroke or traumatic brain injury. A person with Wernicke’s aphasia will have no problem speaking, even in long sentences. However, the words that they’re saying may not make sense or be real words. This type of speaking is sometimes referred to as “word salad” because the speech tends to include random words and phrases thrown together.

Additionally, a person with Wernicke’s aphasia will have a hard time understanding spoken language. They may also have a hard time repeating words or phrases, and often have a hard time reading or writing.

Because a person with Wernicke’s aphasia can speak readily, the condition is also called fluent aphasia or receptive aphasia. Wernicke’s aphasia is also one of the most common types of aphasia.

What are the symptoms of Wernicke’s aphasia?

The symptoms of Wernicke’s aphasia include:

• Easy (fluent) speaking
• Speech does not make sense
• Invented words or nonsense words
• Using replacement sounds (e.g. saying “bar” when meaning “car”)
• Replacing words with other words (e.g. saying “mom” instead of “nurse” or using “stuff” or “things” instead of the exact word)
• Having a hard time repeating words or phrases
• Difficulty understanding other people when speaking (often severe)
• Poor reading comprehension
• Difficulty writing (and what they write will look like how they speak)
• Not realizing they’re making errors when speaking

Often a stroke survivor with Wernicke’s aphasia will have few physical limitations after their stroke. Because of this, family or friends may not realize the person has had a stroke and will instead think they are intoxicated (drunk) or having a mental health issue.

What causes Wernicke’s aphasia?

Wernicke’s aphasia is caused by damage to Wernicke’s area of the brain, which is the part of the brain responsible for language comprehension. This is most often due to stroke or traumatic brain injury, although certain infections, brain tumors, Alzheimer’s disease, or other medical conditions can also affect Wernicke’s area.

Which part of the brain is affected?

A person with Wernicke’s aphasia will have damage to Wernicke’s area, typically found in the left hemisphere (side) of the brain. This is the part of the brain responsible for language comprehension.

Wernicke’s aphasia and Wernicke’s area were both named after German physician Carl Wernicke, who originally linked the symptoms of the aphasia to damage in this part of the brain.

How is Wernicke’s aphasia diagnosed?

A speech-language pathologist (SLP) will diagnose Wernicke’s aphasia using a series of language tests and based on the patient’s symptoms. SLPs are trained clinicians who can recognize the symptoms of Wernicke’s aphasia and ask the patient specific questions to confirm the diagnosis. Some of these questions might include:

• Commands: “Touch your left nostril with your right hand”
• Naming objects: “Where do you sit to eat dinner? Name all the fruits you can think of.”
• Fluency: “Tell me about your family.”
• Repeating: “Repeat after me: ‘The fox chased the mouse.’”
• Reading/writing: “Read this sentence for me.” Or, “Can you write down what I say?”
• Medical providers may also use medical scans of the brain, such as an MRI or CT scan to diagnose the cause of the brain injury.

How is Wernicke’s aphasia treated?

The best treatment for Wernicke’s aphasia is speech therapy with a licensed speech-language pathologist (SLP). The SLP will work with your medical provider to treat the underlying brain injury and help the patient learn new ways to communicate or rebuild language skills.

Speech therapy may include:

• Retraining the brain through physical practice
• Using alternative communication tools, like communication boards or augmentative and alternative communication (AAC) devices
• Reading and writing practice
• Speech practice

While there is no medicine to treat aphasia, a medical provider may also prescribe medicine to treat the underlying medical condition, such as high blood pressure medication to prevent another stroke.

Can Wernicke’s aphasia improve?

As with any aphasia, recovery and outlook depend on how severely Wernicke’s area has been damaged. Speech therapy is the best tool to treat Wernicke’s aphasia. A speech-language pathologist may provide the patient with other ways to communicate, too.

Many patients who have suffered a stroke find their language skills improve the most within six months after the stroke. However, patients can continue to improve over time, especially with support from medical professionals, speech-language pathologists, and their loved ones.

Can Wernicke’s aphasia be prevented?

There is no way to prevent Wernicke’s aphasia. However, you can reduce your risk of acquiring it by:

• Living a stroke-prevention lifestyle
• Wearing protective gear when doing anything that could injure your head (e.g. wearing a helmet when riding a bike or a motorcycle)
• Seeking treatment immediately at the first signs of a stroke
• Managing underlying conditions such as Alzheimer’s, infections, or brain tumors

What is it like to live with Wernicke’s aphasia?

Although people with Wernicke’s aphasia may have a hard time saying what they mean or understanding others, there are many ways to manage the condition and regain communication or learn new ways to communicate.

Medical providers and speech-language pathologists can provide the patient with tools to help them communicate alongside treatment for Wernicke’s aphasia. Many SLPs help their patients find new ways to communicate, such as AAC devices, communication boards, or other methods.

Research shows that patients with strong support systems from friends, family, and loved ones can also have better outcomes. SLPs can help teach caregivers, family members, and friends tricks to help their loved one with Wernicke’s aphasia, like:

• Speaking in shorter sentences
• Waiting for the patient to process what’s been said
• Asking yes or no questions
• Don’t correct the patient

SLPs may also teach caregivers and loved ones how to use tools like AAC devices to help their loved one with Wernicke’s aphasia communicate and practice their speech therapy.

What emotional or psychological effects can occur?

People with Wernicke’s aphasia often report that they feel frustrated or isolated because of their communication challenges. Some can develop depression or anxiety or withdraw from social situations.

Medical providers may prescribe antidepressants or other medications to help manage depression or anxiety. Support from loved ones and caregivers can also help a patient with Wernicke’s aphasia.