By: Grace Slater
The Neurological Relationship Between Epilepsy and Speech
Speech and language depend on multiple regions of the brain working together to process, organize, and produce communication. During a seizure, abnormal electrical activity can disrupt these neural networks, affecting the way information is processed and expressed. The impact depends on where the seizure occurs, how long it lasts, and whether seizures happen repeatedly over time.
Seizures involving the dominant left hemisphere are more likely to affect language because this side of the brain is responsible for many aspects of speech and language processing. When Broca’s area is involved, a person may have difficulty planning and producing speech or speaking fluently. If nearby language regions are affected, they may have trouble finding words, processing language, or understanding what others are saying. Some individuals also experience postictal aphasia, a temporary loss of language abilities that can occur after a seizure.
When seizures occur during childhood, they can interfere with normal language development. As the brain is forming new neural connections, recurrent seizure activity may interrupt the way speech and language skills are learned. Although the developing brain is remarkably adaptable through neuroplasticity, the new pathways it creates are not always as efficient as the original ones. This may lead to persistent challenges with speech, language, reading, or literacy, even when other academic abilities remain strong.
The Role of Speech Language Pathology
Speech language pathologists evaluate how neurological conditions affect communication and determine which areas need support. Assessments may include speech production, language, cognition, reading, swallowing, and oral motor function depending on each person’s needs.
Treatment is individualized because no two people with epilepsy experience the same communication challenges. Therapy may focus on improving speech production, strengthening language skills, developing compensatory strategies, or treating oral myofunctional disorders such as tongue thrust. The goal is to strengthen functional communication while promoting neuroplasticity through repetitive, meaningful practice.
Home practice is an important part of therapy because repetition helps reinforce new neural pathways. Reading aloud, practicing target speech sounds, word retrieval activities, and oral myofunctional exercises can all support progress when completed consistently. Short, focused practice sessions are generally more effective than occasional long sessions because they encourage steady learning and carryover into everyday communication.
My Personal Experience
For me, the connection between seizures and speech therapy was not something I understood until adulthood. Growing up, I had grand mal seizures. I was fortunate to have excellent neurologists who helped manage my epilepsy, but one important piece of my history was never fully connected until years later. I also have a tongue thrust, where the tongue pushes against the front teeth instead of resting on the roof of the mouth. My orthodontist referred me to a speech therapist to correct my tongue position before getting braces.
After reviewing my childhood EEGs and MRI scans, my speech therapist explained that one of my most significant seizures had affected my left hemisphere near Broca’s area, which is responsible for speech production. She told me I had spent my life compensating for subtle speech and language differences without even realizing it. Because my brain was healing while I was developing language, it affected how I learned and articulated certain speech sounds and how I processed language.
Growing up, my mom and teachers wondered if I had dyslexia because I often read words backward and struggled with reading, even though I excelled in almost every other subject. I loved writing and expressing my ideas, but grammar and different facets of language never came as naturally to me. For years, I felt like I was missing something that everyone else seemed to understand.
In just a few speech therapy sessions, my speech therapist solved one of the biggest mysteries of my life. She connected my medical history with my speech and language challenges in a way no one else had. For the first time, I felt seen, heard, understood, and validated instead of feeling like something was wrong with me.
That experience completely changed my perspective on speech language pathology. Before meeting my speech therapist, I had no idea how much they could uncover answers about the why the way I was. She gave me answers that helped me better understand my own brain, and that experience inspired me to become a speech language pathologist. Today, I am in graduate school pursuing that goal, and I hope to provide others with the same understanding, validation, and support that my speech therapist gave me.
References
American Speech Language Hearing Association. (2017). Assessment and treatment of language disorders in children with epilepsy. American Journal of Speech Language Pathology. https://doi.org/10.1044/2017_AJSLP-16-0195
American Speech Language Hearing Association. (2013). Neurogenic speech and language disorders in epilepsy. Perspectives on Neurophysiology and Neurogenic Speech and Language Disorders. https://doi.org/10.1044/nnsld13.3.10
American Speech Language Hearing Association. (2022). Motor speech phenotypes in pediatric epilepsy. American Journal of Speech Language Pathology. https://doi.org/10.1044/2022_AJSLP-22-00176
ASD Clinic. (n.d.). Speech and language therapy for epilepsy. https://www.asdclinic.co.uk/conditions/epilepsy/speech-and-language-therapy-for-epilepsy.php
Epilepsy Disease. (n.d.). Temporary aphasia after a seizure. https://epilepsydisease.com/clinical/temporary-aphasia-seizure
Epilepsy Foundation. (n.d.). Thinking and memory. https://www.epilepsy.com/complications-risks/thinking-and-memory
Flint Rehab. (n.d.). Speech therapy exercises. https://www.flintrehab.com/speech-therapy-exercises/
MedlinePlus Genetics. (n.d.). Epilepsy aphasia spectrum. U.S. National Library of Medicine. https://medlineplus.gov/genetics/condition/epilepsy-aphasia-spectrum/
NeuroSkills. (n.d.). Speech therapy exercises to practice at home. https://www.neuroskills.com/about/news/speech-therapy-exercises-to-practice-at-home/
