Complaints & connections · borters.ch
Aphasia
In aphasia thinking stays fully intact — only the road between thought and word is cut.
Also known as: aphasia · language loss · post-stroke language disorder · word-finding difficulty · Broca’s aphasia · Wernicke’s aphasia · global aphasia
Open in the tool — with search and all the links →This compilation is for information and replaces neither medical diagnosis nor treatment. If you have symptoms, see a doctor.
In aphasia it is not thinking that is lost, but access to language. That is the single most important sentence here: the person is as clever, as adult and as much themselves as before — only the road between thought and word has been cut. Aphasia has nothing to do with intelligence, confusion or dementia, even if it can look that way from outside. The cause is damage to the language regions, usually in the left half of the brain: most often a stroke, less often a bleed, a tumour, an injury or an inflammation. The forms differ markedly. Some people speak fluently and in full sentences, yet the content stays empty or turns into invented words. Others struggle haltingly for every single word but say exactly the right thing. Almost always, understanding, naming, reading and writing are affected too, to very different degrees. The greatest improvement happens in the first weeks and months, but even after years intensive speech therapy still brings real gains — patience genuinely pays off here. In Switzerland speech therapy is prescribed by a doctor and covered by basic insurance, alongside neurology and neurorehabilitation. For relatives what matters most: speak slowly and in short sentences, allow time, do not finish the sentences — and never talk as if to a child. Any suddenly new language problem is an emergency: call 144. How this is worked on in speech therapy — amount, duration, limits and the signs that are urgent — is ordered by age at logopaedie.borters.ch. If imaging still shows brain tissue that can be saved, mechanical removal of the clot remains possible even beyond six hours.
A new language problem means suspected stroke. Every minute counts — do not wait, do not sleep on it.
The biggest gains come in the first months, yet even years later regular practice still moves things forward.
Slowly, short sentences, one topic at a time, eye contact, radio and TV off — simpler, not louder.
Do not finish their sentences. Tolerating a pause is the most helpful patience there is.
No baby talk, no talking over the person’s head. Thinking is intact — and so is dignity.
Yes/no questions, paper and pen, pointing, gestures, photos or a communication board take huge pressure off.
Shopping list, phone calls, card games, table talk: real situations work better than isolated drills alone.
Withdrawal and low mood are common and treatable. Aphasia groups and peer support relieve both sides.
No drug brings speech back. What counts is practice and its amount: speech therapy works clearly in reviews from about five to ten hours a week, and barely below that — the dose matters more than the method. The greatest recovery happens in the first three to six months, but progress is still possible years later. Piracetam and similar drugs showed no reliable added benefit in comparisons.
About one in three people after a stroke initially has aphasia; in about half of those it largely recedes in the first weeks. The greatest recovery lies in the first three to six months, but progress is still possible years later. Reviews show a clear effect from about five to ten therapy hours a week — under two hours it is barely measurable. Understanding usually recovers before speaking.
Two things sound similar and are not: disturbed articulation with a properly built sentence — or language itself affected. One is motor, the other linguistic.
Mid-sentence it stalls, the word gets described or a similar one grabbed — the knowledge is intact, only access fails.
Plenty of talk in full sentences, but with invented words — relatives often describe it as “suddenly talking nonsense”.
Single words or telegram-style sentences at great effort — yet exactly on point, and the listener notices.
Long sentences, several speakers or background noise overwhelm; short simple sentences do get through.
The letter, the newspaper, the signature: what was automatic suddenly no longer works as before.
Language failing from one minute to the next, often with a drooping mouth or weak arm: call 144 at once.
No value measures the language disorder. These values concern the cause behind it and the prevention of the next event — that is the real task here.
After a stroke this value is among the few that demonstrably change what follows.
If atrial fibrillation is the cause, protection against the next clot is central. This value belongs to the monitoring of certain blood thinners.
Without B12 the insulating layer of the nerves is not maintained. A lack causes tingling, numbness and unsteadiness in the dark — and it is one of the few reasons for nerve trouble that can be fully undone if found early.
The nerves cover their energy needs through thiamine. It runs short with alcohol, after stomach operations, with long-lasting vomiting and under water tablets.
Here both count: a lack harms the nerves, and too high an intake over months harms them as well. Supplements therefore belong taken in a dose that has a reason.
Works together with B12. Given alone, folate can improve the blood count while the B12 deficiency goes on damaging the nerves — which is why both are looked at together.
The amount of practice is here the only quantity with clear evidence: intensive speech therapy over several hours a week brings measurably more than scattered single sessions, and it works even years after the event. No preparation comes near that order of magnitude.
In Europe and Japan long in use after stroke. The large ICTUS trial with 2 000 mg daily found no advantage in recovery overall; individual analyses found small effects on language. It is well tolerated — only the expectation belongs set to that size.
Clearly worthwhile and well supported when deficient — vegan, older adults, certain drugs. No energy boost without a deficiency.
In pregnancy clearly established against neural-tube defects, otherwise mainly with deficiency. Can mask a B12 deficiency — watch both.
A severe low blood sugar can cause a speech disturbance that looks like a stroke — and it is fixable within minutes. This is why with any sudden loss of speech the sugar is measured first of all.
After a stroke T3 often falls while TSH stays normal. That is not a thyroid disease but the body switching to saving mode — it is not treated with hormone.
A meal is an everyday moment with familiar words and objects. Speech therapy uses this — nutrition itself changes nothing about the language loss.
For language it is speech therapy, and there too the amount makes the difference. Intensive programmes over weeks do better in studies than scattered single sessions.
AWMF 030-046 · S2e · 2022-11 — extended
Akuttherapie des ischämischen Schlaganfalls
checked 2026-09