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Approach to the patient with aphasia

David Glenn Clark, MD
Section Editor
Mario F Mendez, MD, PhD
Deputy Editor
Janet L Wilterdink, MD


Language is a distinctive human facility for communication through symbols. Aphasia is the loss of ability to produce and/or understand language. This usually manifests as a difficulty speaking or understanding spoken language but reading and writing are also usually impacted. Aphasia can also impact the use of manual sign language and Braille.

This topic reviews the clinical assessment of aphasia, the major aphasia syndromes, and an initial approach to diagnostic evaluation and management. Specific conditions that cause aphasia are discussed in detail separately (see appropriate topic reviews). Other aspects of the neurologic examination, as well as the prognosis and treatment of aphasia, are discussed separately. (See "The detailed neurologic examination in adults" and "The mental status examination in adults" and "Aphasia: Prognosis and treatment".)


A large, complex neurocognitive network, usually located in the left hemisphere, subserves the capacity for human language [1].

Language centers — The language network comprises areas of perisylvian cortex, including the classical language areas of Broca and Wernicke. While these are not anatomically discrete areas, important neural networks subserving critical language function have been identified:

Broca's area or Brodmann's area 44 in the posterior inferior frontal gyrus innervates adjacent motor neurons subserving the mouth and larynx, and controls the output of spoken language.

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Literature review current through: Nov 2017. | This topic last updated: Nov 21, 2014.
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