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A broken speech bubble puzzle with mismatching pieces.

Lost in the Fog: Aphasia and Brain Fog

Aphasia is a condition where the communication center of the brain has neurological issues. It normally occurs in people who have had a stroke. Migraine attacks have symptoms that are very similar to a stroke too. For me, the aphasia is accompanied by brain fog. These symptoms are definitely a one, two punch during a migraine episode. It is incredibly hard for me to function with these two working to disrupt my life. I’ve had to make at least a couple of trips to the emergency room because my wife was so concerned with my uncharacteristic and disoriented behavior. Luckily there have never been any signs of a stroke.

The early signs of a migraine attack

I remember being a bit out of it when I had a migraine attack. It’s a feeling I couldn’t always put my finger on but I knew it was real. Going into a migraine had always been hard for me to notice. The symptoms were subtle and sneaky. I’d yawn excessively, I had a hard time staying on task mentally, and my left field of vision would get distorted gradually. I thought it was the lack of sleep or just the usual drag I felt in the afternoon after being at work for several hours. Then came the forgetfulness, loss of my thought train, and jumbled speech to mention a few symptoms. I knew what I was going to say but couldn’t get the word(s) out. It was downright frustrating and at times scary. It was like my brain had seized up like an engine with no oil!

Brain fog and difficulty focusing

During an attack, the aphasia usually passes once I’m out of the prodrome phase, but the brain fog lingers. I have always been accustomed to being able to multitask with no issues, but with brain fog, all bets are off. I find I have to really focus on just one thing and one thing alone. If I get into more than that I can be assured the task will not get done, or I can complete it but definitely not to my normal standard. Even having a conversation requires more focus, and still, there are many times I just get totally stuck and can’t continue with the train of thought. I forget what I was doing, or go to do something and suddenly forget what task I was going to do. Getting lost in the fog is only compounded by the pain of a migraine.

Letting others know about my aphasia and other migraine symptoms

There are many other symptoms that I experience with a migraine attack, but my most concerning is usually aphasia with brain fog. The sheer frustration of being mentally frozen in a world where concise action is needed like yesterday is not at all compatible when you have a migraine! Many symptoms I’ve found ways around, but I haven’t found a way around the aphasia. What I have learned is that I need a good support system in place for when this occurs. My wife is a huge advocate for me, especially during doctor visits. I also made sure my coworkers were aware of my migraine condition, and they were willing to step into the gap and help with my deficit caused by migraine.

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

  • poetdoll
    3 weeks ago

    I, too, have (speech) aphasia that lasts a few hours to a few days after a migraine. I can see the word in my head but I can’t say it. people kind of look at me weird when I start spelling it! you’ll be amazed how many people can’t spell! when I can’t recall a word at all, I just click my tongue. by now my friends and family know I can’t recall the word and help me fill it in! they also know that when I say I’m having a microwave, I really mean migraine!

  • Tom Picerno moderator author
    2 weeks ago

    @poetdoll Thanks for sharing your story. I’m sorry you have to deal with aphasia. It can be so very frustrating! Praying you have many migraine-free days in your future. Tom(migraine.com team)

  • glassmind
    4 weeks ago

    Thank you for bringing awreness to this challenging aspect of Migraine

  • Tom Picerno moderator author
    2 weeks ago
  • glassmind
    4 weeks ago

    A good support system is essential.

    In addition to people, I rely on printed information for the most important things.

    At the er rather than struggle to talk, I just hand over my id, my medical alert cards, my migraine action plan, and my phone with a list of my allergies and other conditions. I’m not going to struggle to remember that I’m allergic to meloxicam. I can barely remember that on a migraine free day. And I’ve got 10 med allergies. Lol

    I also use my medical alert cards in other situations where I just struggle to exsist and articulate. Here’s my card. Lol. It says basically “I have Migraine.” And lists my most common,symptoms including speech and thinking difficulties.

    So helpful!

  • Principessa
    4 weeks ago

    I too have suffered with extreme cognitive impairment since the onset of my chronic migraines 5 years ago. It started off as brain fog, and has gotten progressively worse over time. I was a highly successful attorney at the top of my game and intellect was always my most valuable asset- now I am on disability, was forced to quit my job, stop driving, move out of my condo, etc.. I rarely feel good enough to leave the house, except for doctor appointments, and that applies to most days of the month, not just the days when I am suffering from a migraine attack (which accounts for about 15 days/ month). Even on the days when I am pain free, I feel completely debilitated from functioning in daily life. From severe short term and long term memory loss, the development of false memories (which feels like your brain is literally playing tricks on you, Undoubtedly the scariest symptom of all), the inability to communicate effectively, complete lack of focus and ability to concentrate, let alone multitask! Going from a career where my intellect was challenged in the most fulfilling ways possible to a disability that has made me feel like a complete idiot has caused a critical blow to my self image and identity. I thought for sure that I had early onset of Alzheimer’s, but my neurologist ruled it out, and did not make the connection between the brain fog associated with the episodic migraine attacks and the constant cognitive impairment. I truly feel like the loss of my ability to use my brain like the superstar I’ve always been, has been the hardest part of my disability.

    BUT- I have a glimmer of hope that I hope I can pass on to you. I recently discovered Neurofeedback, and have been exercising my brain to retrain , rewire and heal the damage that has been inflicted on my brain. Go online and watch Dr Andrew Hill talk about the treatment. He is a genius, who has worked wonders for me re all kinds of symptoms that I’m working to manage (both migraine and bipolar related). But cognitive impairment has been one of my top priorities and even tho I still don’t feel a sufficient subjective improvement, my QEEG brain mapping over time definitely exhibits an objective improvement of two standard deviations in a myriad of of areas. This treatment is a huge investment- both financially and time-wise. It requires 3 months of treatment consisting of 3, 30 minute sessions a week. Because of my disability, it took my me closer to 6 months to complete the 40 sessions, and given my multitude of problematic symptoms that I want to work on, I will definitely need more treatment to get to where I want to be. But I truly have faith in Dr Hill 100% and if you are lucky enough to live in one of the 6 locations that he set up where neurofeedback is administered (Peak Brain Institute)- I cannot stress how life altering this treatment can be to treat all kinds of brain issues, including migraines and the cognitive impairment associated with it. Do yourself a favor and check it out if you don’t know about it already!! And if anyone has experience with it, please share your thoughts!!!

  • Allyson.Ellis moderator
    4 weeks ago

    Principessa, I hear how much you endure living with migraine. It is so heartbreaking when migraine interferes with your life and and brain function to the point you cannot perform in your career to the standard you once could. The need to give up a career you loved is so discouraging. I’m glad you are finding some hope with neurofeedback! All people respond uniquely to treatment options so what is offering you some relief for your symptoms may not have the same response for someone else. Thank you for sharing your experience and your story with the community. Please keep us posted on how you are managing. Wishing you a gentle day. ~Allyson (Migraine.com team)

  • Bunny01
    4 weeks ago

    I didn’t realize memory lapses could be caused by migraines! I forget things I shouldn’t. I do have brain fog too. I just thought it was because of my meds.

    I do take a prevention med for migraine. I finally talked to my neurologist about my migraines. I see him for a rare seizure disorder. But he put me on Topamax. I haven’t had a debilitating headache since. If I feel a headache coming, I take 2 Excedrin Migraine. That with the Topamax takes care of it.

  • Tom Picerno moderator author
    2 weeks ago

    @Bunny01 I’m glad to hear you are seeing a neurologist. Definitely memory issues can be part of migraine symptoms. They are not permanent thankfully. Just be aware that even though Topamax is a first-line preventative it can cause cognitive issues. It is known as dope-a-max lol. I was on it for a short time and my brain really struggled at times to function like it normally did and I also got kidney stones. Monitor yourself and remember there are many other preventatives besides Topamax. Keep the lines of communication open with your neurologist.

  • jachristopher1024
    4 weeks ago

    Bunny01 with Topamax you get it all double. Not only are your migraines causing the brain fog and aphasia but the Topamax while definitely reducing your migraine days is also giving you brain fog and aphasia. When I see my doctor in a few weeks I’m talking to him about some of the newer medications to see if any of them would be a better option.
    I’m also contemplating having my IUD removed since it seems after lots of reading it seems to cause the same symptoms and that can’t possibly be good for my brain

  • mrsmack
    1 month ago

    Wow! This! So This!! My aphasia gets worse as my migraine pain increases. When it is really bad, I am reduced to just gestures. My wonderful family understands this, and we have worked out some things to do when I am beyond communicating. When it isn’t too bad, but I just can’t find the right words, my husband makes jokes. I will pause speaking while I search for the right word, and he will say ” what is it? Sounds like? one word, two words?” like we were playing charades instead of me groping for clarity. This may sound callous, but he is doing it with love and helps me to see the lighter side of things. He knows when I’m in the mood for this levity, and when not to tempt the migraine beast.

  • glassmind
    4 weeks ago

    With my family, we generally just all stop using words and switch to either slow, limited sentences (if on the phone and those calls end up short conversations delayed for another time), emojis or pictures only for texts (if I’m even able to use a screen), or body language, gestures and expressions in person.

    My aphasia is worst during an attack, so I’m usually more focused on dealing with symptoms like pain and nausea than trying to talk anyway.

  • kattracx
    1 month ago

    Sometimes my vision would sharpen to such clarity. This was a signal that a migraine was coming. Mostly my vision blurs so badly that my eyeglasses are useless. I would have to darken the room with a light just on my work in able to read it. Other migraines would cause pain on the top of my head if I tried to pull up a memory or figure a solution to a problem. This was on top of the constant pressure pain and nausea I feel with a migraine. I would have to off the lights and close my office door because the brain fog and pain were too severe for me to function. I lost a job opportunity because of my migraines. Social security did not consider my migraines a disability because I stopped going to the neurologist for treatment. Too many adverse reactions to medications. I just go to bed now and do what needs to be done when I can.

  • glassmind
    4 weeks ago

    Funny, while I get visual disturbances like white stars, blurred or tunnel vision, I occassionally get hyperclear vision also.

    You are the first other person I’ve heard mention it.

    I have better than 20/20 vision usually, but some aura will make my vision seem almost predatory. Like hypersensitive to motion and all distances seem to be in equal super clear focus. It’s very surreal.

    When I have that type of visual aura I usually also have hyperclear hearing and smell also, feel on edge/hypervigilant, and experience anorexia along with alice in wonderland syndrome.

    The first few times were so confusing. Suddenly being in this altered state.

    Now I know it is aura, but in the actual aura it is hard to recognize it as such. Other types of aura I have, I more readily can identify as aura.

  • reneepeyregne
    1 month ago

    Thank you so very much for sharing. I like many others here; have had these same issues, and the doctors that have evaluated me say “there is nothing wrong” (psychiatrists, speech advisers, cognitive specialists, etc) .. I thought I was having early onset Alzheimer’s or dementia. I am a disabled Vet, and get my healthcare through the VA system, and they have been very attentive, but could not figure out why I was having memory and cognitive issues on a regular basis. I see my doctor again next week; I will mention this to him.
    Thanks again.

  • Savta45
    1 month ago

    Reneepeyregne!
    ABSOLUTELY you should do that! I’m assuming that because you are on this site, you are having other migraine symptoms as well, right? Goodness! It REALLY UPSETS me when I hear of our Vets, the people who have served our country & sacrificed for it in doing so possibly getting less than the SUPERLATIVE CARE they ABSOLUTELY deserve!!!
    If nothing else, this information may put your mind at rest about this issue, & that may free you up to an extent. G-d knows, I’m sure you have plenty of other items on your plate to deal with, in any case!
    May G-d bless you, & keep you in the palm of His hand, brave soldier, airman/woman, Sailor, Marine. Thank you for your service. PLEASE, be as assertive as you need to be, to get the service you deserve, the service you EARNED!!!

  • Savta45
    1 month ago

    Hello Tom & everyone,
    The topic you so beautifully describe is quite similar to that which I also experience. It is reassuring, although somewhat sad, to know that I am not alone in exhibiting this aspect of migraine syndrome.
    Yes, brain fog. I lose track so easily of what I’m doing & why. Things just don’t seem to work. I get EXTREMELY clumsy, which is combined with unsteadiness of gait. I’m not really safe in the kitchen, MUCH LESS driving! I haven’t driven a car in about 5 years. Even if I don’t have a headache/migraine (headaches always morph into migraines), there is no way for me to know if/when I will get one, & if I do, it can go from 0 to 8 in a VERY short time, maybe a couple of minutes. I can act in an irrational, even dangerous, manner when I have a migraine, simply because I’m trying to think around the pain, and it is SUCH a HUGE effort to do that, that everything else shrinks in importance. All I’m really thinking is how to get somewhere where I can get relief. Everything else is so low on the priority list that it’s just a nuisance, & gets in the way of my only true purpose.
    But, the aphasia. I stutter. I NEVER, EVER did that before I started having migraines about 12 years ago. And, yes, I know what I want to say, but, it won’t come out of my mouth. When I was still working, a manager who didn’t know me was SOOOO close to calling 911 because of this, fearing a stroke! And, I couldn’t speak for myself, to explain! What a conundrum! Fortunately, I had co-workers with me, who knew me & knew my situation quite well, who were able to explain & prevent him from calling 911.(BTW, I was essentially obliged to retire early, on disability, due to the migraines.)
    I’m on Aimovig now, for the past 4 months, & it is helping somewhat. Mostly what I’m seeing is that, when I get migraines, they are more effected by pain medication. So, I have to take less pain Med to get relief than I would have before I was on the Aimovig. And, sometimes, I can go for a few days without much head pain at all. That’s REALLY great. It’s not perfect, but it’s a step in the right direction, anyway. Which gives me a bit of hope. And, I SINCERELY NEEDED that hope. I dearly wish for anyone reading this to also have hope, or, better yet, sustained relief.

  • lilacmusic
    1 month ago

    I have experienced Aphasia and brain fog for years- without the headaches- along with severe vertigo, seeing black for a split second, and numbness/tingling all over my body. I have just been recently diagnosed with chronic migraine because I finally started having the debilitating headaches about 3 months ago. I have been miserable for 22 years without knowing why. It’s such a relief to know that this is a regular symptom and that I’m not crazy or having mini strokes.

  • Allyson.Ellis moderator
    1 month ago

    lilacmusic, I am glad you finally have an accurate diagnosis! Living with the uncertainty of “what is this?” especially for so many years can be so scary. You are not alone experiencing migraine without the headache phase. I thought this article might also resonate with you:
    https://migraine.com/migraine-types/silent-migraine/
    Wishing you a gentle day. ~Allyson (Migraine.com team)

  • bluesguy
    1 month ago

    Great article. Thanks for sharing your experiences. I can relate to what you have gone through. It is really embarrassing some times. I can’t get my brain to engage, just as you describe. It is as if I have nothing to say, even if I was involved in a conversation. Like you say, the brain fog can last for days. Thanks for bringing up this topic. It is nice to know I am not experiencing anything unusual.

  • AnnMarieO.
    1 month ago

    Thank you for sharing! I have the same symptoms – excessive yawning, also very thirsty, cannot seem to get enough water, words jumbled up, the right side of my face will go a little numb. I get very irritable because I have to focus so hard to get a task completed (like making dinner, etc.). I used to blame my inability to multi-task I’m having kids but now I think it’s because of the migraines. I told my neurologist ALL of these symptoms several year ago (I’ve had migraines for 18 years now) and she laughed and told me those weren’t symptoms of migraine. It was so disheartening as I was really in a bad state then. These forums are really helpful for validation and ideas on how to help fix/deal with the symptoms. Thanks, everyone, for sharing.

  • Donna L Campbell
    1 month ago

    Omg. I go through this!
    I was getting concerned as my thoughts were “getting stuck” along with my words. Family and friends were starting to fill in the blanks of my conversations!

  • Sie
    1 month ago

    I have the brain fog and confusion also. Reading this makes me feel more normal if that word can be applied.

    I have memory lapses or gaps. I forget how to spell words I shouldn’t. I make mistakes that I never did before and can’t remember how it happened. Its scary. My migraines became chronic 2 years ago. I’m hoping symptoms don’t become worse than what I deal with now.

  • RemoteControl
    1 month ago

    Great article! Like many others, I struggled for years without a diagnosis and seemingly random symptoms. There is so much power in defining the problem and knowing you are not the only person.

    My freak out symptom was not being able to read maps or make spatial relationships work in my brain…. That was when I thought I had a stroke (which is what is happening, mostly). Now that is a day to day occurrence to laugh about, but the first episode was not so amusing. I have zero advice to share but do want to express my appreciation for emotionally nailing this topic.

  • Holly H.
    1 month ago

    I also do this. Here’s what I did… I made a couple copies of a 5.5″ square medical alert out of card stock and have carried them in my purses.
    On the front side is a large light yellow square with a medical red cross symbol on it.
    On that side I put: “MEDICAL INFORMATION on Reverse Side.”
    Then down a bit, I put: “My name is Holly, and I live at [I put the name of the senior towers and their phone number].” Then I put: “Responders: I am allergic to Toradol (pain med).”

    On the back I put (this is not the complete text, but most of it):
    “I HAVE A SEVERE MIGRAINE DISORDER
    If I have a migraine spike, the pain and overstimulation may make me a bit confused and/or disoriented.
    I may not be able to speak well, or I may not be able to speak at all.
    This is not unusual nor overly alarming. It is a neurological episode that comes from a migraine spike.
    Please help me find a seat in a quiet place, if possible, and I should be OK in a few minutes.
    Do not call an ambulance at this point.
    I should be OK shortly… and then I’ll be able to tell you how I need to proceed.
    If this does not clear up within 15 minutes, please call 911.”

    Because I have gotten so bad, I don’t get out much, and if I do, I am with my sister; but I still carry the card in a baggie along with my primary doctor’s business card. It has explained a few times. It did come in handy when I was at Publix one time. I was able to hand that card to someone who showed me to a bench. And, fortunately, that time I did come back to being able to talk well enough to communicate and it went no further, although the cloudy-headedness remained, I managed to find my ride.

  • glassmind
    4 weeks ago

    Yep, pocket med cards for migraine! Love mine. Soooo helpful.

  • JoyC
    1 month ago

    I thought it was just me. Makes me more aware of the subtle signs of an upcoming migraine. Thank you.

  • frustr8d
    1 month ago

    I am stuck in a perpetual state of brain fog with aphasia, nausea and vertigo. Has anyone else ever been “stuck” in a phase?

  • mrs.s.overall
    1 month ago

    Thank you for sharing. This is a regular problem for me as well. Making people in your life aware ahead of time is crucial! It is frustrating for me, but can be terrifying for those around me to witness for the first time. Especially because I can loose function on the left side of my body as well. Unfortunately, my hemiplegic migraines are sudden onset, thus I may not be able to warn someone when it begins.

    I have had to “argue” with Drs. not to call an ambulance when they saw this occur in their offices. Trust me when I say that was extremely difficult to get my point across!

    As a result, my husband now has to accompany me to all my appointments and I no longer drive. I also try to make sure that anyone I may be with, without my husband, knows that this has a possibility to occur.

    Thankfully since I started Aimovig, I am down to only one or two of this type of migraine a month.

  • Cat Mom of Two
    1 month ago

    Tom, I feel like you “climbed inside my brain”!!! That’s absolutely exactly how my migraine experiences have been for most of my life!!! I feel like I just write that store… I have had migraines with auras for at least 20+ years. I’m sure when I was younger then that, I had them on and off but they became a repetitive nuisance 20 years ago. My great grandmother on mom’s side wrote a diary and in there describes “bad headache & fatigue”. Much of the symptoms I had as a teen & up. My female cousin, also on mom’s side, experiences Maddening Migraines, as we refer to them. We are both on Botox injections x 3mo. I also take the new IM injectable med “Aimovig” & “Topamax” three 50 mg tabs daily. My “lovely concoction” keeps things at bey…. not irradicating migraines completely, but making life worth living (Honestly!). I have a history of a stroke which a neuro doc thinks was caused by the migraines, rheumatoid diseases (RA, OA, reynaud syndrome & fibromyalgia) & GI issues just to name a few. I just recently suffered a concussion, July 4th, while cleaning a countertop, I smacked my head into an above my head corner cabinet. Who would thunk THAT would cause all that damage!???!! Now my poor little brain feels like a “weeble wobble” for sure!! (I think I just gave away my age! ‍♀️ )

    Well, my BEST to you and all our fellow “Migraine Warriors”. God Bless all those in the research who give timelessly and tirelessly in the pursuit of medicine in hope that one day NO ONE WILL HAVE TO SUFFER LIKE WE DO!!

    Cat Mom of Two is signing off, to email me.. ” melh_” at hot Male dot commmm”

  • lizzietishlizard5566
    1 month ago

    Great share — Thank you! As I’ve grown older, read more about migraines, and become a nurse so much abt my headaches makes sense in retrospect. (I’m sure so many ppl can relate). Brain fog and aphasia are two biggies. Looking back it’s like ‘duh!!’ Pun intended;)).

    For me the distinct types of aphasia have and do occur as well. I experience what I believe is expressive aphasia. In that I understand what ppl are saying to me completely. However I either can not recall the word I wish to share and I experience a ‘tip of the tongue’ syndrome (similar to that associated w Topomax side effects). Or I know what word I am trying to get out and I just can not for the life of me get the words out.

    This, as a patient, is possibly the most frightening symptom. Particularly because of its similarity to that of a stroke. And the frustration level associated with the loss of the ability to communicate clearly is maddening.

    Hang in there fellow migraineurs!!

  • Tom Picerno moderator author
    2 weeks ago

    @lizzietishlizard5566 thanks for sharing your perspective! I have struggled with aphasia for years and have gone to the ER due to the symptoms being so close to that of a stroke. I was also on Topamax so I understand what that is like as well. No wonder they call it ‘dope a max’ lol! Tom(migraine.com team)

  • BobbyDon
    1 month ago

    This is the best description of aphasia and brain fog. Thank you for your share.
    Jill

  • Tom Picerno moderator author
    1 week ago

    @BobbyDon I’m glad the article resonated with you. I have found over the years that so many migraineurs experience symptoms, but don’t have names for them. There have been too many times I’ve had symptoms I couldn’t quite articulate as well so I try to shed some light on migraine disease and its symptoms. Tom(migraine.com team)

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