trouble getting words out

Hi, @debmc1958 - welcome to Mayo Clinic Connect. Since speech is a major part of our lives, I can imagine difficultly forming words would be challenging.

I'd like to introduce you to @hopeful33250 @imallears @lioness @jakedduck1 @jcbonne1, who may have some thoughts for you as you try and get some answers on this difficulty forming words with tests coming back all negative for stroke, etc.

Will you explain a bit more, @debmc1958, in what way you find difficulty forming words? For example, are you having trouble uttering the sounds, moving your mouth into position to form the words, coming up with the words in your brain that you are trying to get out?

I hope it's okay that I am posting for a friend who is not very internet-savvy. She says that she has difficulty moving her mouth/tongue to form the words. She does not have difficulty thinking. She compensates by using words that she is able to say, has a lot of trouble with "L" "S" "R" and multiple syllable words in particular.

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.

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.

She's been to an ENT and is going again in a couple of weeks. Also had thyroid levels checked. She's also been to a rheumatologist. Also negative for Sjogrens. Also negative for myasthenia gravis. The only thing that showed up in any tests was swollen sublingual gland. No other balance, gait, etc. problems, no headaches/dizziness.

@debmc1958
I believe seeing the doctors that other members have already mentioned are important, however speech pathologists are very capable in diagnosing and correcting a myriad of speech & language disorders. I have a type of aphasia which is due to epilepsy and mine will never fully be resolved although spee h pathologists have been somewhat helpful. Although it is important to rule out any structural problems or diseases. Would you say your friend distorts the letters L, S and R or has trouble with words that either start with those letters or have those letters in them?

@jakedduck1 makes a good point, @debmc1958 about your friend seeing a speech pathologist. Please encourage her to do so. I see a speech pathologist on a regular basis for a paralyzed vocal cord.

@hopeful33250
Hi Teresa,
Do you know why your vocal cord became paralyzed? Do you cough or have breathing issues problems eating?
Is your speech pathologist helping you?
Take care,
Jake

It is considered idiopathic, @jakedduck1. That means they are not sure why. I had surgery 5 years ago at Cleveland Clinic and a Silastic implant was put in the paralyzed cord which helps it close up with the other cord. I have a stronger voice now, I don't choke as easily when eating, however, I still do need to eat slowly and chew food more than typical. I still can choke on occasion but basically much better than before the surgery.

Prior to the surgery, I sounded like I had laryngitis by about 1 p.m. Now I only sound that way if I get very tired.

Yes, speech therapy does help as well as singing. I also use a device that helps strengthen the cords.