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debmc1958 (@debmc1958)

trouble getting words out

Ear, Nose & Throat (ENT) | Last Active: Jan 12, 2020 | Replies (10)

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@predictable

Hello, @debmc1958. Welcome to Mayo Connect and thanks for coming in to help a friend in need. I'm not an expert in this field, so consider my immediate reactions as questions to consider.

First, functions of the brain are governed by different parts of the brain — movement using muscles is directed from a different place than sensing, emotions, memory, creativity, etc. In my case, a "small stroke" deep in my brain — barely visible on computerized tomography (CT) scan — impeded my speech, hand writing, walking, and balancing. After six months of physical therapy, other brain cells are learning how to replace those that were damaged, and I have recovered enough to sing again in public and write thank-you notes to my neighbors.

Second, every disturbance affecting motion and balance below the skull involves nerve signals that pass through the spinal cord. Deviations from normal often originate there rather than in the brain, which comes into focus when stroke is suspected. A problem that might seem to be in the spinal cord could be in a peripheral nerve that is outside the cord and disturbed immediately by bone of a vertebra or by a disc between vertebrae.

Third, it seems to me that a physician specializing in Neurology is crucial to finding a convincing diagnosis of the cause of her disabilities. A neurologist is well-equipped in such cases to call together a team of physicians if needed. If the cause involves facial nerves or blood circulation, a combination of specialties might be appropriate.

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Replies to "Hello, @debmc1958. Welcome to Mayo Connect and thanks for coming in to help a friend in..."

Hello @debmc1958,

I am sorry to hear about your friend's speech difficulties. I would agree with Martin, @predictable when he suggests a consult with a good neurologist. I would add to that a consult with an otolaryngologist (an ENT who specializes in the vocal cords) who can check out the vocal cords, throat, etc.

I'm wondering, however, did these speech problems come on suddenly or have they been over an extended period of time? Has she had any other problems such as balance, gait, walking, using her hands, etc.? Any headaches or dizziness? Any extreme stressors?

A speech therapist might be very helpful to your friend. I would encourage her to keep looking for an answer. Will you post again and let me know how she is doing?

She went to a neurologist and had an MRI. They said no white matter, no stroke. Also had testing that was negative for ALS.