Tell Them Apart
Two terms that get mixed up, compared point by point - with the one 'tell' to remember.
Aphasia Dysarthria Both make talking hard after a stroke - but the breakdown is in different places.
- What it affects
- Language itself - finding and using words
- The muscles that produce speech
- How it sounds
- Wrong or missing words, but clear voice
- Slurred or effortful, but the right words
- Understanding
- Often affected too
- Usually intact
- Reading & writing
- Frequently affected
- Usually normal
Aphasia is a language problem; dysarthria is a speech-muscle problem.
Apraxia of speech Dysarthria Two motor-speech problems that can sound similar but come from different breakdowns.
- Core problem
- Planning the movements for speech
- Weak or poorly controlled speech muscles
- Consistency
- Errors vary - the same word comes out differently
- Errors are fairly consistent
- Groping
- Visible 'searching' for sounds is common
- Not typical
- Automatic speech
- Often easier than deliberate speech
- Similar difficulty throughout
Apraxia is a planning glitch; dysarthria is a muscle-strength/control problem.
Ischaemic stroke Haemorrhagic stroke Both are strokes, but one is a blockage and the other is a bleed - and treatment differs.
- Cause
- A clot blocks blood flow
- A blood vessel bursts and bleeds
- How common
- About 85% of strokes
- About 15% of strokes
- Emergency treatment
- May include clot-busting drugs or removal
- Focuses on stopping the bleed and pressure
Ischaemic = blocked; haemorrhagic = burst. Both are 999/112 emergencies.
Stroke TIA (mini-stroke) A TIA looks like a stroke but the symptoms pass - it is a serious warning, not a false alarm.
- Duration
- Symptoms persist; damage is lasting
- Symptoms resolve, usually within an hour
- Brain damage
- Permanent injury to brain tissue
- No lasting damage on imaging
- What to do
- Call emergency services immediately
- Still an emergency - high risk of a full stroke soon
Never 'wait and see' a TIA - treat it exactly like a stroke.
Dementia Delirium Both cause confusion, but delirium comes on fast and is often reversible.
- Onset
- Gradual, over months or years
- Sudden, over hours or days
- Course
- Slowly progressive
- Fluctuates a lot through the day
- Cause
- Underlying brain disease
- Often infection, medication, or dehydration
- Reversible?
- Not usually
- Often, once the cause is treated
New, rapid confusion is likely delirium - seek medical help urgently.
Dementia Alzheimer's disease People use these interchangeably, but one is the umbrella and the other is a specific cause.
- What it is
- An umbrella term for a set of symptoms
- One specific disease that causes dementia
- Relationship
- Has many causes
- The most common single cause
- Other examples
- Vascular, Lewy body, frontotemporal…
- -
All Alzheimer's is dementia, but not all dementia is Alzheimer's.
Parkinson's disease Parkinsonism Similar movement symptoms, but 'parkinsonism' is a broader description.
- What it is
- A specific disease
- A group of symptoms (slowness, stiffness, tremor)
- Causes
- Loss of dopamine cells
- Parkinson's plus other conditions and some drugs
- Response to levodopa
- Usually good
- Often limited in non-Parkinson's causes
Parkinson's causes parkinsonism, but so do several other conditions.
Physiotherapy Occupational therapy Two rehab professions that overlap - the focus is what sets them apart.
- Main focus
- Movement, strength, balance, walking
- Doing everyday tasks and activities
- Typical goals
- Stand, walk, regain limb function
- Wash, dress, cook, return to work/hobbies
- Tools
- Exercises, gait training, equipment
- Adapted techniques, aids, home changes
Physio gets the body moving; OT turns that into daily life.
Seizure Faint (syncope) Both cause a sudden collapse, but the cause and the clues are different.
- Cause
- A burst of abnormal brain activity
- A brief drop in blood flow to the brain
- Warning
- Sometimes an aura (odd smell, feeling)
- Often lightheaded, sweaty, or 'greying out'
- During
- May stiffen and jerk; eyes often open
- Usually goes limp; quick to hit the floor
- After
- Often confused and drowsy for a while
- Usually recovers quickly once lying down
A faint clears fast; a seizure often leaves confusion afterwards. If unsure, treat a first collapse as an emergency.
Delirium Dementia Both cause confusion, but delirium is a sudden, treatable emergency - and it's often missed.
- Onset
- Sudden - hours to days
- Gradual - months to years
- Course
- Fluctuates a lot through the day
- Fairly steady, slowly progressive
- Attention
- Markedly reduced; hard to focus
- Relatively preserved early on
- Cause
- Often infection, drugs, dehydration
- Underlying brain disease
New, sudden confusion is delirium until proven otherwise - seek medical help promptly, as it's often reversible.
Multiple sclerosis Stroke Both can cause weakness or numbness, but the timing and pattern differ.
- Onset
- Usually over hours to days; can relapse
- Sudden, over seconds to minutes
- Cause
- Immune attack on myelin
- Blocked or burst blood vessel
- Course
- Often relapsing or slowly progressive
- A single event, then recovery/rehab
- Action
- See your MS/neurology team
- Call emergency services immediately (FAST)
Sudden one-sided symptoms = treat as stroke and call for help now; MS tends to build over hours-days and recurs.
Normal ageing Dementia Some forgetfulness is a normal part of getting older; dementia is different in degree and impact.
- Forgetting
- Misplacing keys; a name on the tip of the tongue
- Forgetting whole events; getting lost on familiar routes
- Daily life
- Manages independently
- Struggles with money, medication, or familiar tasks
- Awareness
- Notices and jokes about it
- Often others notice more than the person
- Progression
- Stable over time
- Gradually worsens
It's the impact on everyday life - not the odd lapse - that separates dementia from normal ageing.