Recurrent Wernicke's Aphasia: Migraine and Not Stroke!

Abstract

We report the clinical findings of a 40-year-old woman with recurrent migraine presenting with Wernicke's aphasia in accordance with the results of a standardized battery for language assessment (Boston Aphasia Diagnostic Examination). The patient had no evidence of parenchymal or vascular lesions on MRI and showed delta and theta slowing over the left posterior temporal leads on the EEG. Although the acute onset of a fluent aphasia suggested stroke as a likely etiology, the recurrence of aphasia as the initial symptom of migraine was related to cortical spreading depression and not to stroke.

Episodic Aphasia Associated With Cortical Spreading Depression After Subdural Hemorrhage Evacuation

“…1,2 The clinical diagnosis remains challenging without the other concomitant features such as headache because CSD can mimic seizure or acute stroke. 3,4 In this case report, we discuss our multimodal diagnostic approach and treatment in a patient with episodic aphasia and neurological deficits in order to propose the diagnosis of CSD after subdural hematoma evacuation.…”

“…1,2 The clinical diagnosis remains challenging without the other concomitant features such as headache because CSD can mimic seizure or acute stroke. 3,4…”

Aphasic Aura During Electronic Communication

“…Brief episodes of aphasic aura may occur more often than recognized as it requires communication attempts for it to be noticed. Mishra et al report a case of recurrent Wernicke's aphasia with migraine that lasted over 24 hours and was supported by the Boston Aphasia Diagnostic Emamination 4 . No other literature was found providing objective evidence of aphasic aura with migraine without prolonged aura symptoms.…”

“…Typical aura is usually visual, but sensory, motor, and confusional forms are well recognized. Aphasia is a less commonly reported symptom associated with migraine headache, reported at a frequency of 2.8% in migraine without aura and up to 17% in migraine with aura 2‐4 . Brief episodes of aphasic aura may occur more often than recognized as it requires communication attempts for it to be noticed.…”

Aberrant functional connectivity in anterior cingulate gyrus subregions in migraine without aura patients

“…The angular gyrus is the visual language centre and impaired function can lead to dyslexia ( 23 ). Migraine is a factor in aphasia ( 24 ). The occipital lobe is the main brain area for visual perception and is also responsible for visual language processing ( 25 ).…”