Aphasia and Migraine

Of all the symptoms that can accompany a migraine, few are as frightening as losing the ability to speak clearly. You might be in the middle of a sentence and suddenly be unable to find the right word, or you might find that the words you’re saying are jumbled and nonsensical. This alarming experience is known as transient aphasia, and when it occurs as part of a migraine, it can be deeply unsettling. It’s completely normal to feel scared and confused if this happens to you. The most important thing to know is that this is a recognized, temporary symptom of a migraine aura. This guide is here to offer a calm, compassionate explanation of what aphasia is, why it can happen during a migraine, and why getting a proper diagnosis is so critical.

What is Aphasia?

Aphasia is a language disorder that affects your ability to communicate. It can impact your speech, as well as the way you write and understand both spoken and written language. When it occurs as part of a migraine aura, it is temporary, or "transient." The symptoms usually develop gradually over several minutes and then fully resolve within an hour.

This symptom is caused by the same phenomenon that causes other aura symptoms like visual disturbances: a wave of electrical activity spreading across the brain, known as cortical spreading depression. When this wave passes over the language centers of the brain (which, for most people, are in the left hemisphere), it can temporarily disrupt their function, leading to aphasia.

A Patient's Story: Chloe's Frightening Experience

"I was in a meeting at work, and I went to answer a question," shares Chloe, 41. "The thought was perfectly clear in my head, but when I opened my mouth, a completely different word came out. I tried again, and it was just gibberish. I could hear that it was wrong, but I couldn't make my mouth say the right words. My colleagues were looking at me with concern. I felt a surge of panic, thinking I was having a stroke. After about 20 minutes, my speech slowly returned to normal, and then the familiar, crushing headache began. It was one of the scariest moments of my life."

It is so important to validate how terrifying this experience can be. The feeling of losing control over your own ability to communicate, even temporarily, is profound.

The Critical Importance of an Urgent Medical Evaluation

This is the most critical message in this guide. While transient aphasia can be a symptom of a migraine aura, it can also be a symptom of a stroke or a transient ischemic attack, which is often called a TIA or "mini-stroke."

You cannot tell the difference on your own. Because a stroke is a medical emergency where every second counts, the only safe course of action is to seek immediate medical help.

If you experience aphasia, especially for the first time, please call 911 or go to the nearest emergency room immediately.

A medical team can perform a neurological exam and imaging tests to rule out a stroke. While migraine aura symptoms tend to develop gradually ("the march") and stroke symptoms are typically sudden and maximal at onset, this is not a reliable rule for self-diagnosis. It is always better to be safe and get checked out. Once a doctor has confirmed that your aphasia is part of your migraine pattern, you can develop a plan for how to manage future episodes.

Managing Migraine with Aphasia

Once you have a confirmed diagnosis, the management approach is similar to that for other types of migraine with aura.

Preventive Treatment: If these episodes are frequent or particularly distressing, your doctor will likely recommend a preventive medication to reduce their frequency.
Acute Treatment: Your doctor will also develop a plan for treating the attack once it starts. It’s important to note that for a long time, triptans were often avoided in people with certain types of aura, like hemiplegic migraine (migraine with one-sided weakness). However, more recent evidence has suggested they may be safe for many. This is a conversation that you must have with your headache specialist.
Lifestyle and Trigger Management: The same lifestyle strategies that are helpful for all types of migraine apply here: maintaining a regular sleep schedule, managing stress, staying hydrated, and identifying and avoiding your personal triggers.

Coping During an Episode

Knowing what is happening can make the experience of aphasia less terrifying, but it is still disruptive.

Stay Calm: This is easier said than done, but try to remind yourself that this is a temporary migraine symptom and it will pass. Panic can often make migraine symptoms feel worse.
Inform Those Around You: If you are with people you trust, let them know what is happening. You might even consider carrying a small card in your wallet that explains that you have migraine with aphasia and lists your emergency contact information.
Remove Yourself from Stressful Situations: If you are at work or in a social situation, find a quiet place to rest until the aura passes. Don't try to push through it.
Be Gentle with Yourself: After the aura resolves, you will likely feel exhausted and emotionally drained. Allow yourself the time and space to recover.

You Are Not Alone

Experiencing a symptom as profound as aphasia can feel incredibly isolating. It’s a stark reminder of the complex and powerful nature of migraine. Finding a community of others who understand these frightening and often invisible symptoms can be a tremendous source of comfort and validation.

Trusted Resources

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