“Bruce Willis’s aphasia may have several possible origins”

INTERVIEW – Professor Yannick Béjot, a neurologist, cares for patients with this disorder of spoken, written and read language. He describes the two main forms of aphasia.

Following the announcement by his relatives that Bruce Willis was ending his career due to aphasia, Professor Yannick Béjot, head of the department of neurology at Dijon University Hospital, explains this little-known language disorder that affects more than 300,000 French people.

LE FIGARO.- What does this disease consist of?

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, although they understand what is said to them. It’s 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 they 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 more often than not, 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 that sets in insidiously and worsens over time. They are mainly due to neurocognitive diseases, like Alzheimer’s. Other symptoms, such as memory problems, are often seen but may appear later. The other type of aphasia occurs suddenly, after of a cerebrovascular accident (CVA) or accidental head injury. The other associated signs are paralysis, sensitivity or changes in the visual field. Although we do not know the origin of Bruce Willis’s aphasia, we can imagine that it is rather progressive, since his family has not mentioned any sudden cause.

Are these symptoms reversible?

It all depends on the cause. In case of stroke or trauma, the sequelae can improve and even disappear, thanks to treatment. Progress then occurs 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 the case of neurocognitive disease, the objective will be to stop the decline, to avoid aggravation of aphasia and associated signs by stimulating the damaged areas.

What does the support consist of?

In all cases, it is based on speech therapy that is available according to the patient’s specific disorders. These are exercises based on communication: repetition of words, construction of sentences, understanding of small scenarios, work on semantic fields… The program, which is developed at a rate of one to three sessions per week, is periodically reassessed for the speech. therapist. It can be arranged according to the patient’s tolerance.

How can families be supported?

It is very important that family members can speak with the doctor in charge of the patient, often the neurologist, or with the speech therapist, to fully understand what aphasia is. In fact, it is 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 under-publicized. We often show in the cinema a character who is the victim of a heart attack, never a stroke (while the latter is more frequent than the first). It is a shame because emergency care is essential to limit the consequences. Any sudden loss of language should be considered a red flag.

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