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Acute neurogenic communication disorders are caused by complex damage of various causes—very often of vascular origin—in the structural language network. They present with variable symptoms and degrees. Timely diagnosis and initiation of treatment is of the essence in clinical care. Given an adequate case history/anamnesis, timely decisions are essential with respect to managing vascular and/or epileptic components. In case of difficult diagnosis, medical imaging and/or laboratory parameters should be considered to confirm or exclude metabolic, inflammatory, traumatic, degenerative or psychiatric origin of disease.