Migraine symptoms: Transient Aphasia

It can be a frightening and disconcerting experience to speak to someone and realize that what is coming out of our mouths sounds a bit like a golden retriever.

This is one of the many symptoms of Migraine with Aura that sidelined my personal life. It was also breaking news when Serene Branson suffered transient aphasia in the middle of her live news report.
Aphasia is an acquired condition in which the patient loses the ability to do one or more of the following: speak or understand speech, read or write, perform or understand mathematical tasks.

Aphasia can occur suddenly or over a period of time. In the Migraineur, it is usually a symptom of aura and comes on suddenly. It feels a bit like this – One moment you are speaking and understanding a conversation, and the next moment *POOF*you’re in another country, confused and completely out of your element and out of control.

Thankfully unless the Migraine patient suffers a condition called persistent aura, or permanent damage occurs due to a Migrainous stroke, aphasia is temporary. It comes and it goes. Physicians call this Transient Aphasia, because it is not a permanent deficit. It does not require therapy to overcome.

What happens during an attack of aphasia?

It is now understood that Migraine aura is the result of an electrical wave that pulses across the brain called Spreading Cortical Depression. As the unusual electrical wave spreads across the brain, our neurons fire in an abnormal way and our brains can become confused. We see things that aren’t there. We may feel, hear or smell things that aren’t there too. Even our sense of time and space may be altered. As the spreading cortical depression hits the parts of our brains responsible for these and other functions (such as language) we experience strange aura symptoms.

There are two different parts of the brain responsible for language. They are called Broca’s area and Wernicke’s area. Each area controls different parts of language — 1. Function, and 2. Understanding.

Broca’s area is responsible for function — speaking, reading and writing words and numbers. (Words and numbers are all part of language) Aphasia in this area of the brain is often called non-fluent aphasia or expressive aphasia, because the individual has lost the ability to speak words or sentences, although the ability to understand language has not been affected. The patient will struggle to find the right word or number, and not be successful. The reason these patients have aphasia has nothing to do with loss of motor skills in forming words — it is a neurological phenomenon.

Wernicke’s area is responsible for understanding words and numbers. Aphasia in this area of the brain is often called fluent aphasia or sensory aphasia, because although the patient can speak using mostly normal words, they are often nonsensical – as if the words’ meanings had been re-arranged. The person speaking has no idea they aren’t using language correctly and will often be shocked when later presented with a recording of their conversation. They also cannot understand what anyone else is saying to them.

There are many different ways to classify aphasia, but those classifications are usually restricted to permanent deficits. When the aphasia is caused by Migraine, it is usually and simply called transient aphasia. A patient suffering aphasia is called Aphasic.

Migraine patients often may not simply suffer aphasic symptoms from one or the other area, but mixed types. Additionally, one aphasic experience may not be as severe as the next — or vice versa. Just as each aura is different, each experience with aphasia may be different too. Knowing how our brains work normally and during a Migraine is often helpful however, in relieving stress from the unknown.


Knowledge truly is power! I sometimes have aphasia — what can I do?

  • Carry a wallet card explaining your condition: These cards can be purchased from various aphasia websites, or you can simply create one yourself that says something like: “Hello, my name is ______ and I sometimes suffer transient aphasia as part of Migraine aura or side effect of a medication I am taking. This means I may not be able to understand or speak to you right now. To help me, please call ________.” Don’t forget to warn the person (or doctor) whose phone number you’re using that they may receive a call. Help them by providing them with instructions you would like them to give the caller such as: How to contact someone for transportation home. Where your medical information is located. Where you store your medications so a helper can get them to you. How to contact your spouse or physician.
  • Carry an instruction sheet that includes the information above, as well as contact information for significant others who can help you.
  • Carry a small pad and pencil with you.
  • Carry a smart phone with GPS tracking enabled. An example of one program that allows “friends” to see where you are is: Google Latitude
  • Consider creating a one button text code to a loved one that indicates your situation when you’re alone.
  • Remember to create an auto dial number for ICE on your phone (In Case of Emergency) and direct it toward someone close to you who is usually available. Emergency personnel depend on these numbers and will look for them. Multiple ICE numbers can be followed by #1, #2, etc. May also code APHASIA with an emergency number in your phone too. This will help emergency personnel or helpers to assist you.

Remember — no matter how confused and alone you feel, You. Are. Not. Alone.
What can my loved ones do to help me?

  • Keep paper and writing tools handy “just in case”.
  • Use gestures if necessary.
  • Speak slowly and carefully and give plenty of time for single word responses.
  • Use drawings or pictures to be understood
  • Educate yourself about Migraine and aphasia so you can advocate for your loved one when they have lost their own voice.
  • Plan ahead and practice — what will you do if you receive a call from someone trying to help your loved one?
  • Be ready with hugs of encouragement. Don’t lose patience. Give plenty of time for your loved one to try to communicate with you.
  • Be sure to summarize a thought or idea you think they have and give them the opportunity to nod or shake their head to indicate their agreement or disagreement.
  • Remember this is a temporary situation beyond their control. They are alone and scared.
  • After the attack is over, review together what happened and make any changes to your plan necessary for the next time.

Aphasia and Migraine medications

Aphasia is sometimes a part of Migraine aura (often mistakenly called Complex Migraine — an antiquated term) but it can also be a side effect of preventive medication you may be taking for your attacks. Be sure you cross check all your prescriptions for this potential, no matter how rare they may list it. Gabapentin and pregabalin are two examples of medications that list aphasia as a potential side effect. Do you know of any others?

If you have recently (last 6 months) changed your preventive and suddenly are experiencing transient aphasia, consider talking with your doctor about it. Any changes in your normal Migraine pattern needs to be discussed anyway. Your aphasia may be a symptom from your medication and changing meds may be warranted to see if the symptom disappears on its own. Your own aphasia may be short and not affect your life much at all. Then again, it may be serious and even necessitate major life changes like it did with me. Either way, it is a severe symptom that you will want to be sure and minimize. This means education and becoming proactive.

Do you have additional ideas for readers dealing with transient aphasia? What is your story?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Migraine.com team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

Comments

View Comments (22)
  • Libbyjean
    8 months ago

    Aphasia and neck pain are what my migraines consist of. I rarely have a headache. At times i cannot communicate at all. And cant understand much of what is said to me. Have trouble writing an email to tell my boss i cant work or need to leave. Very frustrating. The ONLY Thing i found to help is benadryl. Bekool strips help my neck pain too. Ive been prescribed diff meds but benadryl is it. Then im wiped from that but its better than the aphasia. Weather is my trigger.

  • Renevague3
    2 years ago

    Lately, when I have migraines I have trouble finding words to use or I’ll mix them up or use the wrong one. I once called a tissue box a toothbrush at work before quickly correcting myself. Another time I had two parts of a sentence I was going to say and I mixed them up so I said the opposite of what I meant. Sometimes I have to pause in the middle of a sentence searching for words. It’s so subtle and mild that not even my husband notices. I hesitate to call it aphasia because it is so mild, but these experiences only occur during a migraine.

  • mrst53
    2 years ago

    I have these “Aphasia” migraines for over 30 years. At first I thought I was going crazy, until I found a doctor who explained back then that I was releasing too many hormones too fast. That was the explanation back then. He at least made me feel better. He said a lot of women had these symptoms. My symptoms included my right side, feeling numb and feeling like I was dragging my right foot and not being able to say my name. It lasted about 1/2 hour. These episodes occurred when I was under a lot of stress, like when my husband and I were arguing or things were going bad at work. It’s been a while since I have had one, but I just had one the other day. I am late, getting things wrapped for Christmas and I feel like I am under a lot of pressure and the last thing I needed was a headache of any kind and of course I got the “complicated” kind and the next day I had a migraine. I am still behind but it will all be ok by Christmas 🙂

  • Claudia C
    3 years ago

    I have had painful migraines since childhood. (light & sound sensitivity & dizziness). I rarely get them now. I’m 63. I am often “at a loss” for words, which is embarrassing at times. My eyes get weird lights or floaters, blurred vision & sometimes “pinhole” vision. I guess these are “aura” symptoms. I have been on omeprazole for years (GERDS). In the last year I have been on increasing doses of gabepentin for neuropathy. I had never heard of transient migraines before. Now I’m wondering if this is what is happening to me. The blurred & pinhole vision is quite scary at times…like when I’m driving. I did find out through a brain MRI that I have a fundibulum (small bulge in an artery) due to history of migraines. This is the start of an aneurysm & it may or may not get bigger. I never realized all of the issues associated migraines.

  • Claudia C
    3 years ago

    MENIERES DISEASE! sorry…

  • Claudia C
    3 years ago

    Menieces disease…darn auto correct!

  • Claudia C
    3 years ago

    I also have a rare form of Menieces disease called Drop Attacks where I actually fall for no apparent reason. I take Clonazepam & Diazide for this. Do these medications affect transient migraines too?

  • Claudia C
    3 years ago

    I have had to go to the ER 3 times in my life for migraines.

  • Jennifer Cruts
    3 years ago

    The first time this happened to me, I went to the ER and was diagnosed with a somatic symptom disorder. I have a minor in psychology and just happened to know that symptoms have to persist for 6 months for that diagnosis to even be considered. I knew the “professionals” were being negligent, but I feel sorry for the next person to present with an aura and be told they are just insane.

  • chienjouet
    10 months ago

    This was my experience. I had Aphasia with a Migraine and the ER staff insisted I was having a stroke, and that I was mentally confused with a headache. After 6 hours of testing and them yelling ‘What time is it??!!’ They were becoming more and more frustrated with me, they gave me Morphine with Benadryl and my head cleared up. I don’t know if it was the medication or the Migraine past, but it was a nightmare of an experience. I refused the MRI and left the ER. I’m going back next week for an Open MRI, but I will be filing complaints about the exercises they put me through while I was suffering a migraine.

  • CindyB
    4 years ago

    I have had all varieties of migraine over the years since I was a child – with/without aura, aura without migraine, numbness, visual disruptions and transient aphasia (loss of words, not understanding).

    I am now older, rarely have headaches, but occasionally have visual aura symptoms.

    Recently, I took an extended course of omeprazole. During the time I took it, I noticed symptoms very much like a mild version of the aphasia and confusion I had experienced more severely with migraines. (“Mild” meaning I struggled to find words, and had some problems with completing thoughts, but didn’t sound like a drunk crazy person). I thought perhaps I was becoming senile.

    I stopped taking the omeprazole, and the symptoms were gone within a day. Omeprazole lists “confusion” as a potential side-effect, possibly related to magnesium deficiency. I have taken magnesium for years on the recommendation of a neurologist and migraine specialist. My GP poo-poos this, but the difference was dramatic and quite clear to me – the symptoms came on somewhat slowly, but vanished almost immediately.

    I am reaching out to see if anyone else has information on this.

    Thanks!

  • Jill M.
    3 years ago

    Your comment really interests me. I need to research this…I’ve been on omeprazole for quite a while and often have transient aphasia with my migraines. I wonder if there’s a relation…

  • steve123
    5 years ago

    Thanks for sharing the information Ellen as there if very little information out there on this subject. My neurologist says that this is quite a rare form of migrane.

    I have ‘atypical migraines with transient aspasic aura’. I used to have them daily which would affect cognitive reasoning with speech, reading and writing. During of my migraines, they would render me with the lack of ability to speak coherently, failure to be even able to type simple e-mails or any word recognition and unable to write. To the extent that I was also unable to read simple kids books to my 3 year old son. I found all this very scary.

    I suffer the ‘atypical migraines’ with aura, but the challenge the doctors had was that they were ‘atypical’, therefore I wasn’t in any form of pain, which the doctors struggled to understand.

    Thankfully, after speaking to 2 different doctors I was referred to a neurologist and I had MRI scans and various other brain assessments.

    I am now taking Pizotifen daily which helps with the severity of the aura of the migranes. I do still get them, but much less infrequently than I used to and not as severe.

    I understand Nola, I am in a job where I constantly talk and meet with clients and people within my company and I have to be able to communicate freely and articulately and my migraines became a problem.

    The part that helped me was the second doctor that I saw was happy to state that he didn’t know everything and referred me to a specialist and he worked through his list of things that it could be until he came up with a diagnosis and label.

  • katdan1026
    2 years ago

    I also have atypical migraines with aura. I usually have transient aphasia before a migraine occurs. Usually it is very short, only lasting a few minutes. Today was bad, I was shopping and suddenly started studdering then couldn’t talk. The more I tried the more frustrated I became so I finally gave up and started using hand gestures. My husband asked if I was faking it told meto “stop acting silly”. Even those to you don’t understand the effect thus disease has on you.

  • Nola
    5 years ago

    I almost always get expressive speech aphasia in conjunction with a migraine attack. A week ago, I had something new happen – I couldn’t write a sentence that made sense. I’ve always been aware of the speech aphasia, it’s a real problem as a teacher trying to lecture to class. But this was the first time for the writing problem. The worst part, I wasn’t aware (at the time) that what I was writing was near gibberish. It wasn’t until about 24 hours later that I saw some of the things I’d written and was basically shocked.

  • Stefania Ashby
    7 years ago

    I had migraine aura during a job interview a couple of months ago… which wasn’t unusual until the aphasia came. The WORST timing possible to not be able to speak coherently is during a job interview. Wish I would have had one of those cards.

  • Shawna Paul
    7 years ago

    I am so glad that I found this article. I can always tell when a migraine is coming when I start using the wrong words. I always know when it happens though. I knew that it was migraine related, I just did not know that it was so common.

  • Rambow Fam
    7 years ago

    true dental can fix anything.

  • Christina Bosman Fulton
    7 years ago

    Just last week a friend was telling me that once her partner had a migraine and kept asking her for a hamburger. Only to find out later that he was trying to ask for a kleenex.

  • Natalie Wiseman
    7 years ago

    I think things I want to say but sometime don’t know the words! This migraine disease is horrible!

  • Jessica Smith
    7 years ago

    I had 1 episode of aphasia. It happened while I was at work. Harder part to mine is a combo of migraine & epilepsy. The two feed off each other. A migraine can trigger a seizure or the seizure will trip the migraine. The co-workers who were present for the aphasia episode were calm & helpful with it. When it was over to every-ones surprise I was able to laugh & make fun of my self. My twisted sense of humor has helped make it easier to deal with all the issues.

  • Libbyjean
    8 months ago

    I also have epilepsy and my partial seizures have aphasia also.. So im not always 100% sure which is happening seizure or migraine. The migraine aphasia generally keep getting worse till they go away.

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