When Words Fail: Understanding Migraine Aphasia

Migraine aphasia involves trouble with speaking or verbal comprehension during an episode that usually lasts about an hour. It’s temporary and can be treated with migraine medications.

Each person with migraine experiences migraine episodes differently, with different combinations of symptoms before, during, and after attacks.

Some people may experience difficulties with speech and language during migraine episodes. These symptoms are part of what’s known as transient aphasia, or migraine aphasia.

Here’s everything you need to know about migraine aphasia, including what migraine aphasia is, symptoms of migraine aphasia, and how to treat migraine aphasia.

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What is migraine aphasia?

Migraine aphasia is a form of transient aphasia, a period characterized by temporary issues with language and speech that clear up with time.

Generally speaking, aphasia is a disorder that affects speech and language. It may impact your ability to speak, write, read, listen, or comprehend speech or text.

Aphasia may sound scary, and it can certainly feel scary as symptoms are happening. However, migraine aphasia and transient aphasia are temporary, whereas general aphasia symptoms may be permanent.

Migraine aphasia isn’t caused by brain damage or a degenerative neurological disorder the way general aphasia is. It’s actually a type of migraine aura.

What is migraine with aura, and what does it have to do with aphasia?

Migraine auras are the temporary cognitive disturbances that some people experience during migraine episodes.

Auras happen during the aura phase of an episode, which comes after the prodrome but before the attack phase. This means that auras generally occur before any headache pain or other migraine attack symptoms.

Migraine with aura is a distinct migraine diagnosis, given to people who experience at least one type of aura during at least some migraine episodes. About 1 in 4 people with migraine have migraine with aura.

Over 90% of those who experience auras have visual disturbances, like bright lines or flickers of light appearing in their field of vision.

Other types of aura may also occur, including trouble with speech and language — aka migraine aphasia. Of the people who have migraine with aura, 2024 research indicates that 13.7% experience speech and/or language aura.

You may experience migraine aphasia during some episodes, but not during others. Other episodes may include other types of auras (or no auras at all). Different auras can also occur in the same migraine episode. For example, you may experience visual disturbances and migraine aphasia.

People who have migraine with aura and primarily experience migraine aphasia will almost always experience visual aura during at least some episodes.

What are the symptoms of migraine aphasia?

Migraine aphasia is the third-most common type of migraine aura after visual and sensory auras.

Migraine aphasia symptoms affect your speech and language abilities, impacting:

• word recall
• speaking rate
• sentence syntax
• articulation
• verbal comprehension
• reading comprehension

Migraine aphasia may also affect the physical abilities needed for talking. The muscles in your lips, mouth, and tongue may have trouble forming sounds and words, while fatigue may make it harder to navigate long periods of speaking.

These symptoms may be more closely related to migraine dysarthria or difficulty with the physical act of speaking. This can result in:

• slurred speech
• garbled speech
• very slow or very rapid speech
• mumbling

What happens when you experience migraine aphasia?

When you try to speak, migraine aphasia may make it harder to find the right words or string together a coherent sentence. You may speak in short or incomplete sentences, or mumble disjointedly.

You may confidently say the wrong word or even make up nonsense words without realizing it. You may mix up letters mid-word by switching around the letter order or throwing in letters that don’t belong.

When you try to listen, migraine aphasia can make you lose track of the subject mid-conversation or even mid-sentence. You may have a hard time understanding or following what others are saying.

When you try to read, words and letters may swim together. Even if you can make out the words, you may be unable to follow what you’re seeing.

As for your perception of migraine aphasia, you may or may not notice what’s happening. For example, you might think you’re speaking clearly when you’re not making much sense to others at all.

On the other hand, you may be aware that you’re struggling, sparking feelings of frustration and fear.

While migraine aphasia symptoms can be upsetting or frightening in the moment, keep in mind that they will go away. As with all auras, migraine aphasia symptoms are fully reversible and don’t cause or stem from permanent neurological damage.

How long does migraine aphasia last?

Like other types of auras, migraine aphasia generally lasts about 1 hour. Symptoms will likely resolve themselves as the migraine episode progresses or ends.

However, it’s possible for auras to last longer. Some may last for a few hours or, rarely, for a couple of days — although this is mostly the case for rare motor symptoms.

Keep in mind that different people experience auras differently. You may experience migraine aphasia for shorter or longer amounts of time than others. Duration can even vary between migraine episodes.

Speech and language symptoms

Additionally, general trouble with speech and language unassociated with migraine aphasia may occur throughout migraine episodes.

For example, it’s common for symptoms like brain fog, difficulty concentrating, and fatigue to last until or originate in the postdrome phase, sometimes called the “migraine hangover.”

Clinically speaking, migraine aphasia has likely resolved itself by this stage of migraine, but cognitive symptoms can continue to make communication and comprehension more difficult than usual.

Generally, migraine aphasia is not a cause for concern. However, consider consulting your doctor if:

• aphasia suddenly occurs for the first time
• aphasia continues after other migraine symptoms have entirely subsided

Seek immediate medical attention if aphasia is accompanied by sudden numbness or weakness, or sudden trouble with walking or coordination, as these may be signs of a serious medical event such as a stroke.

How to treat migraine aphasia

Treatment for migraine aphasia currently focuses on overall migraine prevention and reduction. If you prevent migraine episodes from occurring, you also prevent migraine aphasia from occurring.

Options aimed at specifically treating migraine aphasia and auras are limited, and more research is needed.

Depending on your situation, your doctor may prescribe typical migraine medications, like:

• triptans
• calcium channel blockers
• beta-blockers
• antidepressants

Outside of medication, other migraine prevention strategies may also help prevent migraine aphasia, including:

• restorative yoga practices
• regular physical activity
• stress reduction
• acupuncture
• healthy sleep hygiene

The bottom line

Migraine aphasia is a type of aura that can impact your speech and language abilities during migraine episodes. Aphasia symptoms may feel scary but remember that they’ll resolve as your migraine episode passes.

If you experience migraine aphasia, typical migraine medication or lifestyle interventions may help reduce and prevent both migraine episodes and aphasia symptoms. You and your care team can work together to build the treatment strategy that works best for you.