Autoimmune and Migraine Aura Oddities: Amazing Adventures in Aphasia

Aphasia - neurologic difficulty processing language, either given or received.

Aphasia can occur as a result of central nervous system involvement in autoimmunity, as well as in Migraine - usually as part of aura.

There are three basic types and of aphasia. If it comes and goes, it is called Transient Aphasia. If it does not go away, it is called Aphasia. A person who is suffering aphasia is called Aphasic.

Different areas of the brain are responsible for different parts of language, which includes reading, writing, speaking, understanding, and calculations (math).

Aphasia in Migraine

It is not a common type of aura, but it does happen and should be taken very seriously. Unfortunately, these auras can imitate stroke and TIA's so perfectly that it can be very difficult to tell which it is, even by physicians. Although the symptoms may feel the same, the two start out very differently.

Stroke and TIA usually are the result of either a blockage of blood flow to the brain resulting in damage and death of neurons, or a bleed which deprives surrounding neurons of needed oxygen.

In Migraine aura, the symptoms occur as a result of spreading cortical depression. A wave of neurologic activity flows across the brain resulting in disruption. The location of the wave determines what type of aura you experience. If the wave involves the area responsible for eyesight, you will see visual oddities. If it flows thru the part of the brain that is responsible for smell, you might smell something odd that isn't there. In the case of transient aphasia, the wave involves the areas of your brain that help you recognize and create communication.

Aphasia in Autoimmunity

When there is CNS involvement in autoimmunity - almost any kind of autoimmunity - aphasia is a possibility. In the case of autoimmunity, aphasia is often more long-lasting than in a temporary Migraine aura. It's possible that the damage can sometimes be permanent. It is difficult to overlook this type of aphasia when it occurs as a verbal or comprehension issue. However, care should be taken that aphasia affecting reading, writing and mathematical calculations are not dismissed. Many patients suffering this type of aphasia will need evaluation and therapy to regain some of their abilities. The process is long and frustrating, but verbal communication is a vital part of being a human being, and as such - well worth the effort.

Aphasia as a side-effect

This is a good place to also mention that there are some Migraine preventives and chronic pain medications that can have aphasia as a side effect. It's wise for Migraineurs and autoimmunies not to assume their aphasia is a part of their attack and seek help as soon as possible - even if it's transient. Check your medications and be sure a change there isn't in order to prevent further attacks. Talk to your doctor and explain it to family and friends so they can help you during an attack.

Remember -

Someone with aphasia has not lost intellect. They may be able to understand you, but not answer you. They may be able to answer but only a word or two. They may not be able to add or subtract, read or write. They may have trouble finding the correct names for things, even the subjects they may be talking about. They may have strange reactions,
such as laughing inappropriately. Describing something may not be possible for them. For more information on the different types of aphasia, please visit The National Aphasia Association.

Aphasia of any type is frightening - I've been there. When you are suffering from its severe forms, you are cut off from the world. I've been to many other countries, but aphasia is much worse than simply not speaking the language of the land. To me, it's more like sitting in an empty house, watching television that is in another language. You can't talk to them, and you may have trouble understanding them if they try to speak to you. You can't interact with them. It's embarrassing when people assume your intellect is impaired. They don't understand your frustration (which can become profound) and isolation, but often continue on as if you aren't there. Depression may easily follow. People may laugh and not understand that when you tell them you are mathematically challenged, you really are. Their perspective is different. Aphasia is very difficult to understand and appreciate by someone who has not experienced it.

The NAA has an excellent page that helps family members to communicate and can be found HERE. Aphasia Hope has a forum for those dealing with the condition. Those who have suffered a non-transient form of aphasia may find special speech therapy software helpful in rehabilitation. One version is found HERE. For an amazing description of aphasia, you can see the incredibly popular TED tv video posted here on WEGO Health about a neuro-anatomist who suffered a stroke called "Jill Bolte Taylor: My stroke of insight"




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