What Causes Aphasia In A Migraine Attack? The Inability To Speak Or Understand Words?


Asked by JP

What Causes Aphasia In A Migraine Attack? The Inability To Speak Or Understand Words?


Hi JP,

Aphasia, as you said is the inability or loss to understand words and can be part of the aura phase of a Migraine attack. Anatomy of a Migraine discusses all four phases of a Migraine attack.

Dr. David Dodick explained aphasia like this:

"The cause, we believe, is an underlying hyperexcitability of the brain, particularly involving the neurons and glial cells in the cerebral cortex. This underlying hyperexcitability periodically gives rise to a spreading wave of activity in these cells that travels across the brain at a rate of about 3 millimeters per minute, usually beginning in the occipital cortex, the part of the brain responsible for vision. This is why the symptoms evolve over time, and when tingling occurs, spreads from one body part to another.

Once these neurons discharge, they become exhausted and take some time to recover. The activation of these cells leads to what we call "positive" symptoms — for example, sparks, lights, prisms in the vision and a tingling feeling over the body. When the cells are exhausted and recovering they can't be activated, and we believe this accounts for the loss of vision, or scotoma, and numbness or loss of sensation that sometimes occurs. This spreading wave is called "spreading cortical depression," and at this time we believe that this is the cause of the migraine aura. There is a lot of ongoing research to try to understand what starts this wave, how this wave leads to headache, how to prevent the process from starting and how to stop it once it has begun." This is from one of his answers at the NY Times Consult blog.

Does that help?


Answered by Nancy Harris Bonk