Speech symptoms

Paramnesias

Language Symptoms

• Global aphasia
• Broca's aphasia
• Wernicke's aphasia
• Anomic aphasia
• Reading disturbances
• Writing disturbances

Global aphasia

"Global aphasia - This is the most severe form of aphasia, and is applied to patients who can produce few recognizable words and understand little or no spoken language. Global aphasics can neither read nor write. Global aphasia may often be seen immediately after the patient has suffered a stroke and it may rapidly improve if the damage has not been too extensive. However, with greater brain damage, severe and lasting disability may result."

(National Aphasia Association's website, Aphasia Fact Sheet, June 22, 1999)

"Something really scary just happened.. our department secretery just came to my door and spoke to me. I didn't understand a word she said!! Nor could I get any words to come out. I just gestured toward my head and managed to say I have a migraine.. and told her to just show me what she was talking about (something about a 'shelf') I finally managed to figure it out with her help. But wow, that caught me by surprise. Half an hour before this happened, I had no trouble at all speaking to one of my colleagues in the office next to mine.

The migraine is just a dull throbbing right now, but with lots of shadowy visual symptoms and nausea. I've just taken one fioricet and one diclofenac, and I'm starting on my first cup of half-caffeine, half-decaf coffee of the day.

I hate these weird symptoms. I always worry that I must seem like a drug addict, with all of these weird migraine-related problems that have to crop up while I'm at work!"

(Mella Wyrden, Livejournal for Support Group for Migraine Sufferers, Subject: language, January 16, 2006)

"It was not so much that I couldn't hear her.. her voice was at a constant volume. It was just that her words didn't make sense in my head.. except for the word 'shelf' (I could picture a shelf in my mind when she said this.. but the other words around it were all garbled)"

(Mella Wyrden, Livejournal for Support Group for Migraine Sufferers, Subject: language, January 16, 2006)

"Hi K, Yes, I did envision a shelf when she said the word.. but nothing else made any sense. Maybe I sould see it because it was the only object-related word in what she was saying to me.

It was really scary to suddenly be without language like that! The only thing I had was 'shelf' so I kept saying 'shelf? shelf?' and gesturing with my hands, like I was trying to get more information out of this one word.

After I got the language part of my brain back, I explained myself to her a bit better and apologised! She said she gets them too, but never has language-related symptoms.

Thanks for giving me a term to go with this problem. It's better to say 'global aphasia' than it is to have people wonder what kind of crack I've been smoking before coming to work. It gets depressing when I can't function. It's very isolating. I can't even joke about it with people at work who've never experienced it or don't understand it, because it sounds too bizarre!"

(Mella Wyrden, Livejournal for Support Group for Migraine Sufferers, Subject: language, January 16, 2006)

"Wow.. thank you so much for your diagnosis. You've made me feel so much better. I'm glad it's something that's been documented.

After reading more about global aphasia this afternoon on the internet, I feel very sad for those in whom it's a chronic condition. It put me into such a panic to feel alienated from my language all of a sudden. If I hadn't at least had 'shelf' to grasp at like a life preserver, I would have felt completely lost.

And I do feel much better now.. thanks :)"

(Mella Wyrden, Livejournal for Support Group for Migraine Sufferers, Subject: language, January 16, 2006)

Broca's aphasia

"Broca's aphasia - This is a form of aphasia in which speech output is severely reduced and is limited mainly to short utterances, of less than four words. Vocabulary access is limited in persons with Broca's aphasia, and their formation of sounds is often laborious and clumsy. The person may understand speech relatively well and be able to read, but be limited in writing. Broca's aphasia is often referred to as a 'non fluent aphasia' because of the halting and effortful quality of speech."

(National Aphasia Association's website, Aphasia Fact Sheet, June 22, 1999)

"Wow - I am glad to hear that some other people have this symptom too. When I get a right hemisphere migraine, I often lose the ability to speak, apart from one or two words - for example, the first time it happened, no matter what I tried to say, all that would come out was 'career'. Unfortunately, on one or two occasions, it hasn't been such an innocuous word that I have been able to say! I can understand what people are saying, and can read, but can't write, think (verbally) or speak. One of the most disconcerting things is that it becomes very quiet in my head - I guess we take for granted that we think to ourselves a lot of the time, but when the words aren't there, the silence is pretty daunting. One interesting thing from this phenomenom is that you should be able to tell which hemisphere is dominant for speech - in my case the right hemisphere, as I lose feeling in the left side of my body during the same migraine."

(Fiona Bremner, Newsgroups: alt.support.headaches.migraine, Subject: migraine speech problems, December 3, 1998)

Wernicke's aphasia

"Wernicke's aphasia - In this form of aphasia the ability to grasp the meaning of spoken words is chiefly impaired, while the ease of producing connected speech is not much affected. Therefore Wernicke's aphasia is referred to as a 'fluent aphasia.' However, speech is far from normal. Sentences do not hang together and irrelevant words intrude-sometimes to the point of jargon, in severe cases. Reading and writing are often severely impaired."

(National Aphasia Association's website, Aphasia Fact Sheet, June 22, 1999)

"Yes!! I'm here!!! The confusion and problems with speaking usually set in after the first signs of the migraine for me (numbness, aura). However, I haven't always had these speech problems with all my migraines--they first occcured when I was about 13 or 14, and got a migraine at school. On the way home, I was trying to talk, and it felt like I just couldn't do it. I would say words, but they were nonsense!! My parents freaked out and thought I was having a stroke or something. They called the Dr. though and he assured them that it can happen in very severe migraines. It's so scary when I experience it though. It feels like not only is half my body gone, but I'm losing my mind too!! LOL!"

(ThatKat, Newsgroups: alt.support.headaches.migraine, Subject: migraine speech problems, November 29, 1998)

"I suffered an episode recently which I believe was a severe migraine attack, but had significant confusion associated with it. It came amid a series of other migraines, with a strong visual factor and with the usual 30 minutes to an hour of duration. I recall being unable to understand spoken language, functionally, during the episode proper. I was unable to follow directions given verbally, but could process visual and contextual cues (non-verbal language). Apparently, my speech was clear (not dysarthric), but 'confused', by reports of others. I have recollection of there being very bright light, with either substantial field cuts or tunnel vision. My memory for specifics of the event is unclear. This has happened before, but not nearly at this level."

(Leslie Sudak, Email to Markus Dahlem, March 11, 2005)

"I've experienced migraine with aura for 15 years (I'm 40), but have found them so fascinating that I leave them untreated. I'm a speech-language pathologist, a profession I chose after experiencing the aphasic effects (among many other perceptions) of my migraine. I just had to understand how language could become so disordered, and for such a brief time. My aphasia usually resembles a Wernicke's aphasia, if I had to categorize it. Auditory comprehension is clearly reduced, fluent language, and word-errors are within the same semantic category, as best as I can tell. This has given me tremendous insight when working with my own patients. Staff often has used me to 'interpret' the disordered language of an aphasic patient, because I somehow seem to understand it... perhaps from my unique perspective?"

(Leslie Sudak, Email to Klaus Podoll, March 11, 2005)

Anomic aphasia

"Anomic aphasia This term is applied to persons who are left with a persistent inability to supply the words for the very things they want to talk about-particularly the significant nouns and verbs. As a result their speech, while fluent in grammatical form and output is full of vague circumlocutions and expressions of frustration. They understand speech well, and in most cases, read adequately. Difficulty finding words is as evident in writing as in speech."

(National Aphasia Association's website, Aphasia Fact Sheet, June 22, 1999)

"I KNOW I have some form of aphasia, too, before the onset of the migraine. It's very irritating for people to have to try and complete my sentences for me. Example: 'Erica, could you make sure the milk gets put back into the....the....oh, it's a simple word, you know what I mean....(exasperated sounds)' 'Mom, do you mean 'refrigerator'?' 'YES!, that's the word I was searching for!' 'Daaaaad, mom's acting really weird again!'"

(Anne Buede, Newsgroups: alt.support.headaches.migraine, Subject: anyone "manic" before a migraine?, February 17, 1998)

"I was just reminded by someone who loves me very much: P that it gets even stranger than I just described: Me: 'Honey, could you....um....you know, (here I begin to make lifting motions with my arms), could you do that thing....that movement where you ...do something....to the milk... so that it gets into the refrigerator?' Erica: 'Mom , do you want me to 'pick up' the milk?' Me: 'Yes'! Erica: 'Daaaaad! Are you sure it's safe to let Mom out of the house...?'"

(Anne Buede, Newsgroups: alt.support.headaches.migraine, Subject: anyone "manic" before a migraine?, February 17, 1998)

"My aura is confusion. I am/ was (just quit!) a public school teacher, junior high. I knew a HA was coming when my students would stop me because I would not speak the words that I thought I was saying (does that make sense?) Somewhat verbally dyslexic!"

(Sandra Mize, Newsgroups: alt.support.headaches.migraine, Subject: Migraine aura??, May 29, 1998)

"I started getting migraines about 10 years ago (when I was 14). The first one I had didn't end up with a major headache (only a minor one), but I got the blind spots, loss of feeling in one side of my body, etc. I then started forgetting words...just every day words and could barely communicate. I was terrified and didn't tell me family, and later, as these became more frequent and associated with the headaches, I realized (and was diagnosed) as suffering from migraines. But still today, when I have a severe migraine, I'm unable to remember basic words and names. Has anyone else experienced this? My typical other symptoms are auras (with EVERY migraine), tunnel vision, numbness on limbs on one side of my body and one half of my lips."

(Michelle Collins, Newsgroups: alt.support.headaches.migraine, Subject: migraine speech problems, November 27, 1998)

"I find I have unusual clarity of thought and speech about 24 hours before the headache. During the headache I find I speak words that I am not thinking of but they come out in a sentence. It is a little scary. For instance, I might try to ask someone to put something on a table, but I will say floor. I am not sure if it is the headache or medication I take. I realize what I have said and try to correct myself. Its very strange."

(Donna, Newsgroups: alt.support.headaches.migraine, Subject: migraine speech problems, December 1, 1998)

"when i have a bad h.a. i stutter some words i'm trying to say or stutter similar words (like cup vs plate) and totally cannot remember some words altogether. also when i am talking, i call these words 'thingies' when i can't remember the name/word and that drives my family nuts as they don't know what the heck i'm trying to say.... but usually it doesn't affect my typing but it sometimes affects my reading, it's weird.... sometimes i think i got caught in the 'twighlight' zone..."

(Sherry, Newsgroups: alt.support.headaches.migraine, Subject: Speech and Migraine, April 29, 2000)

"it's soooo weird when it happens. I can see a picture of the object, etc. in my mind and i know what i want to say but my mouth won't cooperate..."

(Sherry, Newsgroups: alt.support.headaches.migraine, Subject: Speech and Migraine, April 30, 2000)

"For an entire day before a migraine, I can't find, uh, you know, oh yeah, words. Among other things, I have whole days where I cannot find the simplest words and names. Then just before my pain, my face gets bright red and my ears get red and hot. Then pain. I have not noticed any post-migraine problems yet, but the pre- are pretty noticeable."

(Val in Boise, Newsgroups: alt.support.headaches.migraine, Subject: Auras and post-migraines, November 28, 2002)

"Sometimes my speech gets muddled, I stammer, say the wrong word, etc. Unusual considering I'm typically quite articulate. When this 'speech problem' starts, I just look at my husband, shake my head, and say, 'Oh crap, I can't talk for awhile, nothing's coming out right.' And I stop talking until the confusion aura passes. Funny thing is, I can do light reading just fine. So, that's what I do."

(Wildflower, Newsgroups: alt.support.headaches.migraine, Subject: Auras and post-migraines, November 30, 2002)

"I suffered the opposite effect when I used to sufer from migraines (in teens to mid 20's). I almost 'forgot' how to speak. I knew what I wanted to say, but it was as if every single word was on the tip of my tongue but I could not get it out."

(Chevoix, Newsgroups: alt.support.headaches.migraine, Subject: migraines and talking?, December 13, 2004)

"Episode date 3/12/05, ~10:15 a.m. While driving, I noticed a heaviness descend on my head and seeming to shroud my eyes, but from behind, as if from a leaden miasma, from above and within. I noticed mild degree of scintillation in upper bilateral visual field, and a blackening tunnel along the lower left visual aspects. This was difficult to quantify, as this was while driving through a snowstorm, and there was therefore competing visual stimuli. I stopped at a store, with 'deepening' of symptoms. The fluorescent lights of the store seemed to make light unbearable. I has difficulty seeing package labels, though I could read them, part by part, when turning my head and catching bits of the print. I tried to ask the clerk to put some items in one bag, some in another. These words came, in fits and starts:
'Can you do... put... have... them in the same box... no... container... thing that will hold them... it's a bag. Will you put them at the bag'. The words came as a struggle, with great embarrassment and to a puzzled look by the clerk. He said something that I think was affirming my request, and I saw him talking, but could not quite understand the exact words. There was enough contextual information. Note the preserved syntax, word errors in same semantic category. No jargon or neologisms. On observation at the time, I was able to read adequately, noting print materials at the store. On leaving the store for my office (again with fluorescent lighting), I noticed a tingling in my (left) toes, spreading up my foot midway. Moments later, the fingers of my left hand began to tingle, as with pins and needles. I spoke with several people, but felt speech to be effortful and non-fluent, but functional. Vision clearing, but with a heaviness and pressure on my head, especially in the temporal-frontal areas. This heaviness persisted for several hours. The episode seemed to be over by 11:20, over 55 minutes from observed onset."

(Leslie Sudak, Email to Klaus Podoll, March 14, 2005)

Reading disturbances

"Yup, same here. The aura period is just like a stroke, only temporarily. Can't talk straight, can't see straight, can't think straight. Sometimes, can't read properly because the scotomas are in the way, and sometimes can't read properly because the words don't make sense anymore. Yup, yup, yup."

(ThatKat, Newsgroups: alt.support.headaches.migraine, Subject: migraine speech problems, December 3, 1998)

"[This migraine attack was] Over comparatively quickly, around 12 hours... This one, besides the sea anemones, had a new feature that popped up after I sent the post. Any text I looked straight at, I couldn't see the vowels. No spaces where they should be either, just consonants run together. If I didn't look straight at it, they were there. Freaked me out, first time that's happened. Only for a couple minutes at the end of the aura though."

(Elaine M. Brown, Newsgroups: alt.callahans, Subject: Migraine Aura, February 17, 2000; additions in square brackets by Klaus Podoll)

Writing disturbances

"Several hours before a migraine I'll find myself typing like this throughout all my documents: the word 'somewhat' as 'emostahw' "

(Judy, Newsgroups: alt.support.headaches.migraine, Subject: anyone "manic" before a migraine?, February 18, 1998)

"dear me
I wrote 'to' instead of 'too'. It could be my migraine headache.
It stinks.
best
penny"

(Penny Smith, Newsgroups: mensa.talk.misc, Subject: Movies as Art, August 21, 2000)

References

Almeida DB, Arruda WO, Ramina R, Pedrozo AA, Raskin S. [Migraine with aphasia. Report of a family] [Article in Portuguese] Arq Neuropsiquiatr 1999; 57: 111-113.
Bigley GK, Sharp FR. Reversible alexia without agraphia due to migraine. Arch Neurol 1983; 40: 114-115.
Crisp AH, Levett G, Davies P, Rose FC, Coltheart M. Cerebral hemisphere function and migraine. J Psychiatr Res 1989; 23: 201-212.
Dietz TE, McKiel VH. Transient high altitude expressive aphasia. High Alt Med Biol 2000; 1: 207-211.
Evers S, Homann B, Vollmer J. Agraphia as the only symptom of migraine aura: a case report. Cephalalgia 1996; 16: 562-563.
Fleishman JA, Segall JD, Judge FP Jr. Isolated transient alexia. A migrainous accompaniment. Arch Neurol 1983; 40:115-116.
Kay J, Lesser R. The nature of phonological processing in oral reading: evidence from surface dyslexia. Q J Exp Psychol A 1985; 37: 39-81.
Laurent B, Michel D, Antoine JC, Montagnon D. [Basilar migraine with alexia but not agraphia: arterial spasm on arteriography and the effect of naloxone] [Article in French] Rev Neurol (Paris) 1984; 140: 663-665.
Parker DM, Besson JA, McFadyen M. Intermittent alexia. Cortex 1990; 26: 657-660.
Stiefel FC, Ruttner B. Migraine with aura and functional psychosis: a rare differential diagnosis. Gen Hosp Psychiatry. 1995; 17: 389-391.

Author: Klaus Podoll
Last modification of this page: Friday March 25. 2005

Speech symptoms

Paramnesias

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