Coping With Pure Word Deafness

Type of Aphasia Caused by Stroke

Pure word deafness is a rare type of aphasia most commonly caused by stroke. Stroke can be caused either by a clot obstructing the flow of blood to the brain (called an ischemic stroke) or by a blood vessel rupturing and preventing blood flow to the brain (called a hemorrhagic stroke). A transient ischemic attack, or "mini-stroke," is caused by a temporary clot.

Woman yelling into ear of hard of hearing man
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Pure Word Deafness and Language

Language isn't just about words. Language means a person can recognize and use words and sentences. This use of words resides mostly in the left hemisphere of the brain. When a person has a stroke or other injury that affects the left side of the brain, it often disrupts their ability to use language. Pure word deafness results from damage to these language-specific auditory areas of the brain.

People with this disorder feel as though they can't hear when someone else is speaking, even if the person speaking is doing so in a loud voice. However, they have no trouble hearing other sounds, such as a telephone ringing or a doorbell. People with pure word deafness also have an inability to write if they are asked to do so, but they are able to write spontaneously.

Sometimes pure word deafness is the final result of a Wernicke's aphasia that improved. In fact, the only clear difference between pure word deafness and Wernicke's aphasia is that while people with Wernicke's aphasia lose the ability to write comprehensible sentences, people with pure word deafness maintain the ability to write.

When pure word deafness is due to a stroke, it results from damage to both the nerve fibers that connect the part of the brain that processes hearing (primary auditory cortex) and the part of the brain that processes language (the association areas of the superior temporal lobe). Most cases of pure word deafness involve damage to these areas on both sides of the brain. For many survivors, this change profoundly changes their social life.


Many people living with pure word deafness or any type of aphasia wonder how they can socialize if they can't communicate the way they used to.

  • Educate yourself about aphasia so you can learn a new way to communicate.
  • Close family members need to be involved so they can understand your communication needs and begin to learn ways to help with speech and language.
  • Many stroke survivors with communication challenges compensate by writing or drawing to supplement verbal expression or use gestures or a picture communication book, or even a computer communication system.

Family members can also help facilitate communication by:

  • Asking yes/no questions.
  • Paraphrasing periodically during a conversation.
  • Modifying the length and complexity of conversations.
  • Using gestures to emphasize important points.
  • Establishing a topic before beginning conversation.
4 Sources
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  1. Kanter SL, Day AL, Heilman KM, Gonzalez-Rothi LJ. Pure word deafness: a possible explanation of transient deteriorations after extracranial-intracranial bypass grafting. Neurosurgery. 1986;18(2):186-189. doi:10.1227/00006123-198602000-00012

  2. Shoumaker RD, Ajax ET, Schenkenberg T. Pure word deafness. (Auditory verbal agnosia). Dis Nerv Syst. 1977;38(4):293-299.

  3. ZIEGLER DK. Word deafness and Wernicke's aphasia: Report of cases and discussion of the syndrome. AMA Arch NeurPsych. 1952;67(3):323–331. doi:10.1001/archneurpsyc.1952.02320150056005

  4. American Stroke Association. Types of aphasia.

Additional Reading
  • American Stroke Association.

  • Allan Roper and Robert Brown, Adam's and Victor's Principles of Neurology, eighth edition 2005, pp 417-430.

By Jose Vega MD, PhD
Jose Vega MD, PhD, is a board-certified neurologist and published researcher specializing in stroke.