Abnormality of speech needs to be considered first as this may interfere with history taking and subsequent ability to assess the higher function and perform rest of the examination. Aphasia is defined as all disorders of understanding thoughts and word findings. It is of different types i.e. Broca’s/expressive/motor aphasia, Wernicke’s/receptive/sensory aphasia, conductive aphasia, transcortical sensory aphasia, transcortical motor aphasia, global aphasia, and nominal aphasia. Voice production requires coordination of breathing, vocal cords, larynx, palate, tongue and lips. Dysarthria can reflect difficulty at different levels. A combination of dysphasia and dysarthria may accompany internal carotid artery thrombosis or other vessels of the neck are diseased as well. Dysphasia occurs due to lesion of dominant hemisphere, whereas dysarthria occur due to any site. Dysphonia is disturbance of voice production and may reflect either local vocal cord pathology, an abnormality of nerve supply via the vagus, or occasionally a psychological disturbance.