Migraine

Transient Aphasia and Migraine: What You Need to Know

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Transient aphasia is another symptom of migraine with aura that proves what the migraine community has been saying for years – Migraine is not just a bad headache. It is a neurological condition that affects many body systems. Including communication through written and spoken language.

Transient aphasia is a neurological symptom that interferes with the ability to speak, write, read or even understand language. The inability to communicate can be a significant problem, especially if in the middle of a medical crisis such as stroke, head injury or migraine attack.

This article will explore what transient aphasia is and how it relates to migraine so you can better understand these issues and seek help if needed.

**While Migraine Strong writes about the latest in migraine treatments, this is not medical advice. We are patient educators and all information you read should be discussed with your doctor.

Migraine with aura symptoms

The most commonly known symptom associated with migraine with aura is a visual disturbance that usually lasts between 5-60 minutes. This can include flashing lights, black spots, an oil spill type pattern in the vision or a scintillating scotoma. Some people with migraine will also experience tingling or numbness in their arm, leg or face.

Transient aphasia is another form of migraine aura that is less talked about. It can impair the ability to read, write, speak or understand any of these forms of communication. It can also affect math-related comprehension.

As with all migraine symptoms, there is a spectrum of mild to severe which is different for everyone. Some will also experience transient aphasia between attacks and without any other migraine symptoms. It is also possible to have a combination of the migraine-triggered transient aphasias listed below. Many will resolve in a matter or hours, but some have reported having symptoms for several days.

Below is a TikTok video of Cannon Hodge talking about her symptoms of aphasia and how it affects her life. I highly recommend following her TikTok account (@migrainebabe) which is full of migraine tips and information.

Transient aphasia caused by other conditions

Transient aphasia can also be caused by seizures or a TIA (transient ischemic attack) sometimes called a mini-stroke. These TIA’s will temporarily stop blood flow to various parts of the brain. Symptoms of a TIA include:

  • Weakness or numbness on one side of the body
  • Trouble understanding speech
  • Inability to speak

Because the symptoms of TIA’s are similar to some migraine with aura symptoms (hemiplegic migraine for example), it is very important to have any new symptoms of transient aphasia evaluated by a doctor immediately to rule out stroke or TIA.

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Personal experience with aphasia and stroke

In 2014, I had a migrainous infarction (stroke) where stroke and migraine occur at the same time. This is very rare. My primary symptom was an inability to understand anything anyone said to me. At the time, I thought I was tired or maybe that it was a weird migraine symptom. It came on suddenly and lasted for hours and hours. The sudden onset is a hallmark symptom of stroke, whereas migraine aura typically develops over 5-30 minutes and lasts up to an hour.

When I spoke to my headache specialist about it, he said it was likely a stroke. This was confirmed by MRI (magnetic resonance imaging), a special test that shows images of the brain. My experience is part of the reason why new symptoms of aphasia should be evaluated immediately.

Symptoms of transient aphasia

A person with transient aphasia might:

  • Use short or incomplete sentences when speaking
  • Use sentences that don’t make sense
  • Utilize one word in place of another
  • Speak in sounds that don’t make up understandable words
  • Have difficulty understanding the speech of others
  • Have difficulty writing sentences that make sense

Here is a brief YouTube interview clip of reporter Serene Branson talking about experiencing transient aphasia due to migraine with aura, while on the air. In the interview they talk about being diagnosed with migraine with aura and show her aphasic episode that happened on live TV while she was covering the Grammy’s in 2011.

Types or patterns of transient aphasia with migraine

Some transient aphasias may precede migraine symptoms. These are expressed differently based on which part of the brain is affected.

Broca’s or nonfluent aphasia

This type or pattern of aphasia is also known as expressive aphasia and affects the left frontal part of the brain. Broca’s area is responsible for reading, speaking and writing – both words and numbers. People who experience this pattern will have difficulty finding the right word or number to use. Although they have lost the ability to speak coherent sentences, they don’t have trouble understanding what others are saying to them. They might also have right sided paralysis or weakness. (1)

Wernicke’s aphasia

This type or pattern of aphasia is also called comprehensive or fluent aphasia and affects the middle left side of the brain. People who experience this pattern will often use long and expressive sentences that contain extra words and don’t make sense. They don’t seem to realize that others can’t understand them. The ability for them to understand others is also impaired. (1)

Transient global amnesia

Transient global amnesia is characterized by a sudden loss of memory, one that is witnessed, which occurs when the transient global amnesia attack is at its worst. Most people are able to recall previous memories or events during these attacks. They also retain prior learning like how to drive a car, cooking, typing and how to tie shoes for example. This type of transient aphasia affects about 2% of adults and will last 24 hours or less. Transient global amnesia is approximately six times as likely to occur in those that have migraine. (2)

Migraine slurred speech

Many who experience transient aphasia refer to the symptoms as migraine slurred speech. While it is not a medical term, those who experience it will readily understand why the term is used. Migraine slurred speech can present prior to a mgirane attack. However, it can also occur on its own without any other symptoms of migraine occurring at the same time.

Tips for managing with transient aphasia

If you have an established pattern of transient aphasia with your migraine attacks, here are some options to consider which might help you manage when the symptoms start.

  • Set up your in case of emergency (ICE) on your cell phone. You can direct this to call a predetermined phone number of someone who understands what you would like to have happen during an aphasic episode.
  • Consider setting up a pre-arranged, simple text message which you can forward to a trusted friend or colleague to let them know the symptoms have started. It could be as simple as a specific number or letter.
  • Set up a list of questions or ‘request for help’ prompts in your phone that you might be able to point to and ask for assistance.
  • Carry a card that explains that you have migraine aura, what the symptoms are and that they will pass shortly. Set up and print a free card at the National Aphasia Organization.
  • Make sure your GPS tracking is enabled and location shared for your significant others or family. This will help them find you if are unable to communicate with them.

Depending on the pattern of aphasia you have, some of these ideas may or may not work. Customize any of these ideas and hopefully they will prompt you to set up what will work best for you.

Treatments for transient migraine aphasia

The treatments available for migraine aphasia can include anti-epileptic medications and Botox. Also speech and language therapy from a speech and language pathologist can help with aphasia that lasts for a long time or is caused by damage to the brain (such as with traumatic brain injury or stroke).

Reach out to your doctor if transient aphasia is a common migraine related symptom and see what recommendations they have for treatment. Comprehensive migraine prevention can be helpful in controlling migraine aphasia.

Resources:

  1. https://www.mayoclinic.org/diseases-conditions/aphasia/symptoms-causes/syc-20369518
  2. https://neuro.psychiatryonline.org/doi/10.1176/appi.neuropsych.17120353

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Transient Aphasia and Migraine: What You Need to Know

I began having migraine attacks when I was a teenager, but was never properly diagnosed until I was an adult. This began 18 years where I was chronic and mostly intractable, resulting in a migrainous stroke in the summer of 2014. By implementing the protocols from the Heal Your Headache book by Dr. David Buchholz and the Migraine Strong Treatment Pie, I have been able to reduce my migraine frequency to episodic and maintain that since 2015. The end result of continuing to practice these tools is being able to actively participate in my life as a wife, mother, family member and friend. My goal as a migraine advocate, educator, and wellness coach is to help others gain more control over migraine. Let us know how we can help.

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