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Have you ever known exactly what you want to say, yet the word seemed to disappear or
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worse change just as you reached for it?
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Welcome to Migraine Heroes, a podcast for people living with chronic migraines with
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years of pain, misunderstanding and lack of answers.
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I'm Diane Ducarme, I've helped more than a thousand people reduce the burden of migraines
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and feel more in control.
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My mission in life?
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To help a million people.
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Each episode brings you grounded insight into what your body might be asking for and what
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Just to keep you fully supported, this podcast is educational.
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For diagnosis or medication, always work with your doctor.
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Now take a breath and let's dive in.
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In this episode, you will learn why migraine can make familiar words suddenly feel unreachable,
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even when you know perfectly well what you want to say, how to distinguish ordinary migraine-related
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cognitive slowing from a possible speech or language aura, and when a sudden language
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problem requires immediate medical attention.
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Stay with me till the end, because by the end of this episode, you will have understanding
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and word recovery tools you can begin using during your next migraine attack.
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A couple of years ago, I spoke with the first woman who ever described a speech aura to
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And at the first time, I did not even know this was possible.
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I was still discovering just how many different forms migraine can take.
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And I remember her words so clearly.
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She said, I'm here, I know exactly what I want to say, but a different word comes out
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And she described it as though she were standing outside of her own body.
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Her mind knew what she wanted to communicate, but her body seemed to say something completely
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And that conversation stayed with me.
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I could see the despair on her face, the confusion, and the fear, the fear that an experience
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like this can create.
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Because when your own words no longer seem to belong to you, even for a short time, it
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can feel deeply frightening.
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And what struck with me most was how little understanding she had received.
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She did not only need an explanation, she needed someone to tell her, I believe you,
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And actually, you're not alone.
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Losing access to words can be deeply unsettling.
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You may be sitting in a meeting, speaking with your partner, talking to a doctor or
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trying to explain why you need help.
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You know the word, you can almost feel it sitting somewhere inside your mind and on
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the tip of your tongue, but it doesn't come forward.
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And perhaps you just replace it with another word.
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Perhaps your sentence stops halfway.
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Perhaps you point to an object because you cannot name it.
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Or perhaps you simply become quiet because trying to speak feels like pushing through
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And then comes the fear.
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What is happening to me?
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And am I losing my memory?
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Will other people think I'm not intelligent?
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Is something seriously wrong with my brain?
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And please hear this clearly, struggling to find words during margarine does not mean
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that you have suddenly become less intelligent.
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It does not mean that your personality is disappearing.
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It can reflect a temporary disruption in the brain systems responsible for attention,
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processing, memory retrieval, and language.
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But there is an important distinction we need to make first.
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There are two kinds of experiences.
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When people say, I cannot find my words during a migraine, they may be describing one of
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two overlapping experiences.
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The first is general cognitive slowing, often called margarine brain fog.
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And in this situation, you may feel mentally slower, forget what you were about to say,
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or struggle to follow a conversation, or need more time to retrieve names, or ordinary words.
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And this can happen before the migraine, during the painful phase, or during the exhausted
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period after the pain has eased.
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And so that's one type.
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The second experience is a more specific speech or language aura.
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And here, the disturbance may be clearly neurological.
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You may be unable to name familiar objects, produce the word you intend, understand a
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sentence, you may not be able to read normally, or arrange words correctly.
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And the international classification of headache disorders recognizes fully reversible speech
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or language symptoms as a possible form of migraine aura.
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A typical aura generally develops gradually.
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The actual aura is going to last between 5 and 6 minutes for each symptom, and it's going
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to resolve completely.
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And the word gradually here, it really matters.
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You're going to understand why.
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Migraine aura often unfolds over several minutes.
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Of course, the entire migraine attack is much longer.
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But one symptom may slowly build or spread, and another may follow it.
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For example, a person may first notice shimmering vision, then tingling in one hand, then later
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difficulty speaking.
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In contrast, a stroke often produces a deficit that begins suddenly, although real-life representation
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So you should never attempt to diagnose a difference by yourself.
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When some symptoms are new, they're abrupt, they're severe, they're unusual.
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We're going to talk about that again.
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So what does the word finding difficulty actually mean?
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So the medical term for difficulty retrieving the name of a familiar object or familiar
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idea is called anomia or dysnomia.
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So imagine looking at a key, you recognize it, you know what it is, you may even be able
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to say it's the thing that opens the door, but the word key refuses to arrive.
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That is different from a memory being erased.
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The knowledge may still be present, but the path we use to retrieve and express the word
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is temporarily less efficient.
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Some people experience difficulty producing language, others have trouble understanding
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Some know what they want to say, but produce the wrong word.
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A person might say chair, and they really meant table, or use an invented or a distorted
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And these experiences can fall under the broad description of aphasic symptoms, meaning that
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some parts of language production or comprehension is temporarily disrupted.
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Now visual symptoms are by far the most frequently reported form of migraine aura.
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Language symptoms are less common, but they are well documented.
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So there was a 2024 study published in the Journal of Headache and Pain, and it detailed
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interviews where they conducted interviews with 227 adults diagnosed with migraine with
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aura, and speech or language aura was reported by 14% of participants.
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Because these participants were recruited largely through a specialist headache center,
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that number should not automatically be applied to every person with migraine, but still it
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confirms that language symptoms form a meaningful part of the migraine aura spectrum.
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Now, you do not need to have migraine aura to experience language and memory difficulties.
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In 2015, there was a study in Cephalalgia, and they tested people during untreated migraine
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attacks, and again, when they were free from headache.
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And during attacks, participants performed worse in several areas, particularly word
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reading speed, verbal learning, and verbal recall.
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So this helps explain why migraine can make conversation feel difficult, even when you're
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not having a formal language aura.
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Your brain may be processing information more slowly, attention may be pulled toward pain,
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nausea, light sensitivity, sound sensitivity, and the basic task of enduring the attack.
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Working memory, so the mental space that allows you to hold and manipulate information, may
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have less capacity available.
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So what might be happening in the brain?
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Well actually, language is not stored in one tiny box in the brain.
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Migraine requires several brain networks to collaborate.
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You need attention to remain with the conversation, you need memory to retrieve the data, you
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need language systems to select the word, you need motor planning systems to organize
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the sounds, and you need sensory feedback to monitor what you're saying.
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Migraine can temporarily disturb this coordination.
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And so for migraine aura, one leading explanation is a phenomenon called cortical spreading
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This is a slowly advancing wave of altered electrical activity and chemical balance across
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the surface of the brain.
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In other words, word-finding difficulty may not come from one single malfunction, it may
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emerge because a brain already managing pain and sensory threat has fewer resources available
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for rapid, precise language retrieval.
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Now let us add another layer.
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When you notice you cannot find a word, your nervous system becomes alarmed.
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You start monitoring every sentence, you push harder, you silently command yourself, come
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on, say it, what's wrong with you?
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And that pressure creates another cognitive task.
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Instead of using all of your available attention for communication, part of your mind is now
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watching, criticizing, and predicting disaster.
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This does not mean anxiety causes the migraine symptom, it means that fear can make an already
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difficult task feel even more impossible.
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The goal is not to win a fight against your brain, the goal is to help your brain complete
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the task with less pressure.
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Now, a bit of an essential safety message.
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Because sudden trouble speaking can also be a warning sign of stroke, this symptom really
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Seek emergency medical help immediately when difficulty speaking or understanding language
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is sudden, is new, is unusually severe, or is different from your established migraine
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Particularly when it appears with facial drooping, with weakness or numbness on one side, loss
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of balance, sudden visual change, confusion, or sudden severe, do not wait for the symptom
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to pass, and do not assume that this is migraine simply because you have a history of migraine.
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For new patterns, sudden onsets, or unusual symptoms, get medical help.
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And please feel free to re-listen to that, if you have hesitation, re-listen to the podcast,
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just listen to what's the nuance between that brain fog, that speech aura, and this
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medical emergency, and you'll start to really understand the nuance, they really matter.
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Now let us view this experience from another angle.
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Traditional transmissing does not describe word-finding difficulty through electrical
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brain networks or cortical waves.
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It uses a different language, one of movement, nourishment, communication, and balance.
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This is not a replacement for neurological assessment.
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It's a symbolic or a clinical framework that helps us ask a different question.
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Instead of only asking, why is my brain failing to produce this word?
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We might ask, what conditions does my whole system need in order for expression to flow?
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In traditional Chinese thought, clear speech is not seen as an isolated medical act.
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It reflects the cooperation of awareness, memory, energy, emotional regulation, and
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the ability to organize thought into expression.
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The heart, for example, is traditionally associated with the shen, the clarity and presence of
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This does not refer simply to your physical heart muscle.
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It describes the quality of being mentally present, of being settled, of being able to
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connect inner experience with the outside world.
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When the mind is agitated, when it's frightened, when it's exhausted, when it's overwhelmed,
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speech then may become scattered or difficult.
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Then there's the spleen system, and in this traditional language, it is associated with
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thought, with concentration, and the ability to transform experience into something understandable.
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And when this system is described as depleted, a person may experience a heaviness, mental
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fog, repetitive thinking, fatigue, or difficulty organizing ideas.
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Then you have the kidney system, associated with deeper reserves, memory, endurance, and
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unconstitutional energy.
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And after years of chronic pain, poor sleep, fear, and repeated attacks, a person may feel
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that these reserves have been drained.
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And then you have the liver system, associated with the smooth movement of energy and emotion.
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And when movement becomes constrained, expression can be blocked.
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The thought is inside, but it cannot move outward freely.
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So again, these are not anatomical claims.
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They are a traditional map of a human experience.
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And there's something compassionate in this map.
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It suggests that when you cannot find a word, the answer is not always in pushing harder.
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Sometimes the system needs space, quiet, warmth, nourishment, and permission to slow down.
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There's a Chinese saying that can be translated as, when the water is still, the reflection
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So imagine trying to see your face in a bowl of water, while someone is shaking the bowl.
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The harder you stare, the less you see.
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During migraine, your internal water may be already disturbed by your pain, by the light,
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by the noise, the nausea, the fear, the exhaustion, and the sensory overload.
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And demanding immediate verbal precision is like shouting at the water to become still.
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So more traditional wisdom would invite a different response.
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To settle the bowl.
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To reduce the light.
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To reduce the noise.
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To place your feet on the floor.
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To allow your shoulders to fall.
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To breathe out slowly.
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To stop forcing the word.
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And when the demand softens, another route to meaning becomes available.
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You may not remember the word refrigerator, but you may see the cold cupboard in the kitchen.
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You may not retrieve someone's name, but you can see the person you met at the clinic.
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And this is still communication.
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The river has not disappeared, it's simply finding a different path around the stone.
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Many people with migraine have spent years proving that their symptoms are real.
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And we know they are.
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You may have learned to hide pain.
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You may have continued working.
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You may have learned to smile through nausea and produce intelligent answers while your
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nervous system is struggling.
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And when your words disappear, that carefully maintained appearance of control can feel
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And from an Eastern philosophical perspective, this is where softness becomes strength.
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A rigid branch can snap in a storm, and a flexible branch moves with the wind and returns.
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And so during a language disturbance, flexibility might mean using fewer words.
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It might mean telling someone that you need silence.
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It might mean abandoning the sentence and returning to it later.
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It might mean communicating by text, rather than speech.
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The Western mind often says, I must get back to normal immediately.
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A more balanced response might be my system is moving through something.
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I will support it without abandoning safety.
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This is not surrender, it's just a skilled cooperation.
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So this is hard, and it really is, and it feels, and it can be so scary.
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What I'm asking you today is by listening to this podcast, trying to feel, okay, in
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what category is my speech problematic?
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Is that belonging to brain fog?
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Is that belonging to migraine aura?
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Was that belonging to something that requires more urgent medical care?
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And then once you know, how can I cope?
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How can I bring softness in my life?
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How can I regain control?
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How can I find myself again?
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This is a hard one, and remember, every small step you take moves you closer to freedom.
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You are powerful, you are resilient, and you're not alone.
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Keep rising, Migraine Hero.
