Difference between Aphasia and Dysphagia

Aphasia vs Dysphagia

Aphasia is the disturbance in the ability to speak and understand language, both verbal and written. Aphasia is not a disease, but a symptom of brain damage whereas Dysphagia is defined as difficulty in swallowing. There is difficulty in passage of food from the mouth to the stomach.
Aphasia is caused due to damage to the Broca’s and Wernicke’s area of the brain that control language. Damage to Broca’s area causes difficulty in speech production but the understanding is normal. Damage to Wernicke’s area causes difficulty in understanding spoken or written language but the speech remains fluent. Aphasia occurs due to brain injury, brain tumour and viral infections like encephalitis. It is mainly seen in cases of stroke (the blockage/rupture of a blood vessel in the brain). Aphasia is also seen in degenerative diseases like Alzheimer’s disease and Parkinson’s disease whereas Dysphagia is caused due to diseases of the oesophagus like Stricture (narrowing), Oesophageal spasms, Diverticula (sacs in the walls of esophagus), cancers etc. Oesophagus is a muscular tube that moves food from back of the mouth to the stomach. Dysphagia is also caused due to defects in the nerves and muscles that control swallowing. This occurs in cases of head injury, Stroke, Multiple sclerosis, Parkinson’s disease and after an attack of Polio (viral infection causing paralysis).

Patients with aphasia have difficulty in speaking and finding the right words to complete their thoughts. They experience difficulty in reading, writing and understanding language. Aphasia also causes inability to form words, name words and repeat words whereas in cases of dysphagia, patient has a sensation that food is stuck in the throat or chest which causes cough, choking and drooling of saliva. If the food/liquid goes down the wrong way into the lungs, it can cause infections like pneumonia. Patients may also lose weight.

Investigations like CT scan and MRI will help determine the cause of aphasia. The speech-language pathologist (SLP) evaluates the individual and determines the type of aphasia. To determine the cause of dysphagia, the tests done include barium X-ray (Barium solution is swallowed by the patient and the X-ray is taken), Endoscopy, CT scan and Chest X-ray.

Treatment of aphasia will depend upon the cause. If infection is the cause, anti-biotics/antivirals are given. In cases of stroke, antiplatelet drugs etc are prescribed. Once the underlying cause is treated, the patient needs speech therapy. It includes practising language skills and using alternative communication methods like hand gestures, drawing etc. Treatment of dysphagia will depend on the cause. In oesophageal narrowing/spasm, oesophageal dilatation surgery is done. In cases of cancers causing dysphagia, surgical removal of the growth is necessary. The patient is given exercises to strengthen the muscles of the throat. In severe cases, a feeding tube is used to provide nutrition to the patient.

Summary

Aphasia is impaired ability to speak and understand language, caused due to damage to the Broca’s and Wernicke’s areas of the brain. It occurs in cases of head injury, brain tumours, brain infections etc. It is most commonly seen in stroke. Symptoms include inability to speak, read, write and understand language. Neurological tests will help us find the type and cause of aphasia. A Speech language pathologist will provide appropriate therapy to the patient.
Dysphagia is difficulty in swallowing. It occurs in conditions like stroke, head injury, oesophageal cancer, multiple sclerosis etc. It can cause choking and lung infections like pneumonia. Diagnosis is done by Barium X-ray, endoscopy, CT scan etc. Treatment includes exercises to strengthen the muscles of the throat, oesophageal dilatation surgery and insertion of the feeding tube in severe cases.

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