Dysphagia vs Dysphasia

There are two relatively common medical conditions that are treated by the same therapist and afflict the same type of patient — usually stroke patients — which sound virtually identical but are very different issues: dysphagia and dysphasia (pronounce them out loud and you'll see how similar they are).

Both of these conditions are caused by neurological damage to the brain that comes from an injury or a stroke. Both dysphagia and dysphasia are treated by speech therapists and both have to do with a person's ability to control muscles in the mouth and throat.

Woman caressing ill man in hospital ward Rear view of woman caressing ill man in hospital ward
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What Dysphasia Means

Dysphasia is difficulty speaking. It's one of the main symptoms of a stroke that is easily recognized and should be a red flag. Sudden onset of dysphasia indicates the possibility of a stroke or of sudden brain injury. Paramedics say it a lot when reporting to the hospital on our patients in the back of an ambulance. Most paramedics will recognize dysphasia immediately and it is an important indicator of the patient's condition.

Dysphasia is often mistaken as being the same as confusion, but in reality, the two are completely unrelated. It may seem that when a patient is unable to say what she wants to that she is confused. Patients with dysphasia can't communicate verbally, but they often know exactly what's happening. Normally, they can hear perfectly and while they might not understand why they can't say what they want to say, these patients can usually understand what is said to them. Confusion, on the other hand, is the inability of the patient to fully understand his environment or situation.

It's also possible for a patient to have trouble saying anything at all after a stroke. Patients who can't say anything are said to have aphasia (no speaking). Again, they might be able to understand completely or at least understand concepts, even if the exact words don't make sense to them.

To a medical professional who suspects a patient might be experiencing a stroke, there is no significant difference between aphasia and dysphasia. Either one indicates difficulty either processing language in the patient's brain or in the part of the brain responsible for controlling the muscles of the tongue and throat.

What Dysphagia Means

Dysphagia, on the other hand, is difficulty swallowing. Dysphagia is also a symptom of a stroke or injury to the brain, but it's not as readily detected by emergency medical personnel. There's virtually no reason or way that a paramedic would have to test this in a patient. Paramedics don't give very many oral medications in the ambulance. The one common oral drug is aspirin, and we typically give that for heart attacks.

Paramedics don’t give aspirin until we know what kind of stroke the patient is having as it can make certain strokes worse, but it may be administered by a physician later on once we recognize what kind of stroke the patient is having.

However, dysphagia is a huge problem in the hospital because a patient needs to eat. When paramedics transfer patients between facilities, it is extremely important for them to understand what a nurse is telling them during the verbal report. Since the two terms sound exactly alike, it can be very easy to misunderstand the message and think the patient is having a hard time speaking. It is commonly true that patients who've recently had a stroke can also have trouble speaking, which further complicates the issue.

It's extremely important for clarity during a verbal report between caregivers, especially since caregivers are often going to transfer the information down the line in a healthcare version of the telephone game. It makes a lot of sense for caregivers to use proper medical terminology, which usually leads to better understanding. These two terms are the exception to the rule. In this case, it might be better to be plain-spoken and just say the patient is having difficulty swallowing.

When a person who's had a stroke has trouble swallowing — dysphagia — there is a danger of aspirating or choking. Choking is having something block airflow in the trachea. Aspiration is inhaling food or fluid into the trachea. It doesn't completely block breathing as choking does, but aspiration can lead to pneumonia and even death. If the caregiver taking over care doesn't realize the patient can't swallow, the patient could end up becoming even worse.

11 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Dang PD, Nguyen MH, Mai XK, Pham DD, Dang MD, Nguyen DH, Bui VN, Mai DT, Do NB, Do DT. A Comparison of the National Institutes of Health Stroke Scale and the Gugging Swallowing Screen in Predicting Stroke-Associated Pneumonia. Ther Clin Risk Manag. 2020;16:445-450doi: 10.2147/TCRM.S251658

  2. Nakamura T, Kurosaki S. Effects of early dysphagia rehabilitation by speech-language-hearing therapists on patients with severe aspiration pneumonia. Progress in Rehabilitation Medicine. 2020;5:20200020. doi: 10.2490/prm.20200020

  3. Berthier ML, Dávila G, Torres-Prioris MJ, et al. Developmental dynamic dysphasia: are bilateral brain abnormalities a signature of inefficient neural plasticity? Front Hum Neurosci. 2020;14:73. doi: 10.3389/fnhum.2020.00073

  4. National Library of Medicine MedlinePlus. Aphasia.

  5. Wang R, Wiley C. Confusion vs broca aphasia: a case report. Perm J. 2020;24. PMID: 31852049

  6. Philpott H, Garg M, Tomic D, Balasubramanian S, Sweis R. Dysphagia: Thinking outside the box. World Journal of Gastroenterology. 2017;23(38):6942-6951. doi: 10.3748/wjg.v23.i38.6942

  7. National Library of Medicine MedlinePlus. Dysphagia: Swalling Disorders.

  8. Djarv T, Swain JM, Chang WT, Zideman DA, Singletary E. Early or first aid administration versus late or in-hospital administration of aspirin for non-traumatic adult chest pain: a systematic review. Cureus. 2020 Feb 3;12(2):e6862. doi: 10.7759/cureus.6862

  9. Signorelli SS, Platania I, Tomasello SD, et al. Insights from experiences on antiplatelet drugs in stroke prevention: a review. Int J Environ Res Public Health. 2020;17(16):E5840. doi: 10.3390/ijerph17165840

  10. Yu KJ, Park D. Clinical characteristics of dysphagic stroke patients with salivary aspiration: A STROBE-compliant retrospective study. Medicine. 2019;98(12):e14977. doi: 10.1097/MD.0000000000014977

  11. Komiya K, Rubin BK, Kadota J ichi, et al. Prognostic implications of aspiration pneumonia in patients with community acquired pneumonia: A systematic review with meta-analysis. Sci Rep. 2016;6(1):38097. doi: 10.1038/srep38097

Additional Reading
  • González-Fernández M, Brodsky MB, Palmer JB. Poststroke Communication Disorders and Dysphagia. Phys Med Rehabil Clin N Am. 2015 Nov;26(4):657-70. doi: 10.1016/j.pmr.2015.06.005.

By Rod Brouhard, EMT-P
Rod Brouhard is an emergency medical technician paramedic (EMT-P), journalist, educator, and advocate for emergency medical service providers and patients.