Lupus is often thought of as primarily a condition of the skin and joints, although many people are aware that it can also affect organ function. However, not as many people are aware that it can also cause issues with the central nervous system as well—including aphasia, a type of communication disorder. If you love someone who suffers from central nervous system (CNS) lupus, this is what you should know.
What is aphasia?
Aphasia is a communication disorder that can take several forms—the individual may suddenly show difficulty speaking, writing, and comprehending. Their intelligence isn't affected, but the sudden difficulty with communication can be frightening and frustrating. The general symptoms can include
- an inability to convey their thoughts clearly through speech or in writing,
- an inability to understand what he or she hears or sees in writing,
- the inability to find the correct names for objects (although he or she may substitute something similar, such as "couch" for "chair" or "stand" for "desk," often without notice).
Aphasia is a sign of brain damage, however. It is also one of the hallmarks of a stroke, so anyone who suddenly develops symptoms of aphasia should be evaluated as quickly as possible at a hospital to rule out that condition. Once any immediate danger has been ruled out, a neurologist can begin to determine if the aphasia is related to the patient's lupus or another condition.
How is it diagnosed?
Typically, the patient's neurologist will want to do a full examination, including tests like CAT scans and MRIs, in order to provide a clear picture of what is going on and to rule out things like a stroke, brain tumor, or a degenerative disease. There may also be a need for a psychiatric evaluation, especially if there are changes in his or her behavior. The doctor may also order other diagnostic tests, including blood tests and spinal taps, to rule out the presence of any other condition that could be causing the symptoms of aphasia. Expect a number of tests that measure cognitive function—the neurologist will use them to try to pin down exactly what part of the brain is damaged and how badly.
How is it treated?
Treatment can be intermittent or ongoing, depending on the severity of the condition. A speech-language pathologist can help the patient work on activities that will improve the specific language skills that have suffered the most damage. That's why extensive neurological testing of the exact nature of the aphasia is important—a clear diagnosis helps guide future treatment.
Treatment also focuses on life-management skills. The patient's family members may be included in training sessions that will teach them how to communicate more easily with someone who is suffering from aphasia. Remembering to do things like slow down their speech, reducing background noise so that it is easier for the aphasia sufferer to concentrate when speaking or listening, and using "yes" and "no" questions can help.
If you care for someone with CNS lupus, be conscious of any changes in his or her ability to communicate, even if they seem intermittent or slight. Keep in mind that the sufferer may not even be aware that he or she is having problems, so make sure that you alert him or her to the problem and help describe the condition to the neurologist so that an accurate diagnosis can be made and treatment, if necessary, can be started. Reach out to someone like Billings Clinic for more guidance.