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Suggest Treatment For Slow Slurred Speech
Question: Hello,
Over the past week, I have had a change in my speech. The right tip of my tongue does not always seem to raise up to pronounce words with "S" in them, etc. which results in slowed, slurred speech on occasion as well as a bit of a lisp at times. At times, there has been a very mild spasm or twinge inside of my tongue. At any rate, once I stumble through the word, I am usually able to state it again properly without the slur or lisp. Sometimes it is better than others, earlier in the day I was speaking fine, so I thought that perhaps it was just all in my imagination. However, later in the day, when I took my little boy out shopping, I began having some problems again. A few days ago, I woke with very bad cardiac arrhythmias, got up and took a half of a lebetalol which improved the symptoms. I am so terrified about a neurodegenerative disease. I called urgent care to make an appointment since I could not be seen immediately by my physician and they told me to go to the ER. At the ER, a CT scan was performed which showed no abnormalities. They recommended a follow-up with my general practitioner and an MRI. The only other potentially strange symptom that i have been experiencing over the past couple of days is twitching in a couple of my left toes. The ER doc didn't think that the two symptoms were related. I am hoping that you may have some information to ease my mind until I am able to see my physician , or if not, perhaps some questions that I should ask the physician when I seem him. Thank you in advance for your help.
Over the past week, I have had a change in my speech. The right tip of my tongue does not always seem to raise up to pronounce words with "S" in them, etc. which results in slowed, slurred speech on occasion as well as a bit of a lisp at times. At times, there has been a very mild spasm or twinge inside of my tongue. At any rate, once I stumble through the word, I am usually able to state it again properly without the slur or lisp. Sometimes it is better than others, earlier in the day I was speaking fine, so I thought that perhaps it was just all in my imagination. However, later in the day, when I took my little boy out shopping, I began having some problems again. A few days ago, I woke with very bad cardiac arrhythmias, got up and took a half of a lebetalol which improved the symptoms. I am so terrified about a neurodegenerative disease. I called urgent care to make an appointment since I could not be seen immediately by my physician and they told me to go to the ER. At the ER, a CT scan was performed which showed no abnormalities. They recommended a follow-up with my general practitioner and an MRI. The only other potentially strange symptom that i have been experiencing over the past couple of days is twitching in a couple of my left toes. The ER doc didn't think that the two symptoms were related. I am hoping that you may have some information to ease my mind until I am able to see my physician , or if not, perhaps some questions that I should ask the physician when I seem him. Thank you in advance for your help.
Brief Answer:
Anxiety/Drugs induced/Dystonia/MS to consider.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
If you would have presented to me as an outpatient,I would have outlined the following important causes that could be a reason for your symptoms in order of significance:
1)Anxiety-is a potential cause that can cause these symptoms. Please do mental relaxation exercises/ Yoga/ Pranayama and see if these symptoms still persists.
2)Drugs induced-These symptoms are very commonly caused by some of the medicines as their extrapyramidal side effects. Labetalol is rarely (but yes) reported to cause them. Please list other drugs you are taking, so that I can have a further opinion on drugs as a possibility for the same.
3)MS-Yes, MS can be a possibility. But, CT Brain will not pick it up. You will need a MRI Brain (contrast enhanced) for the same.
4)Dystonia-Tongue Dystonia can be a possibility. But, we will have to wait and watch for the same. If no improvement occurs with time, it will have to be given a consideration. Other causes mentioned above have to be ruled out first.
Symptoms in toes appear just to be anxiety related.
If you have any further questions,please be in follow-up else,please close the thread and rate it.
Dr.Ajay Panwar,
MD,DM(Neurology)
Anxiety/Drugs induced/Dystonia/MS to consider.
Detailed Answer:
Hi XXXX,
Thanks for being on healthcaremagic.com.
I am Dr.Ajay Panwar,a neurologist,here to answer your query.
If you would have presented to me as an outpatient,I would have outlined the following important causes that could be a reason for your symptoms in order of significance:
1)Anxiety-is a potential cause that can cause these symptoms. Please do mental relaxation exercises/ Yoga/ Pranayama and see if these symptoms still persists.
2)Drugs induced-These symptoms are very commonly caused by some of the medicines as their extrapyramidal side effects. Labetalol is rarely (but yes) reported to cause them. Please list other drugs you are taking, so that I can have a further opinion on drugs as a possibility for the same.
3)MS-Yes, MS can be a possibility. But, CT Brain will not pick it up. You will need a MRI Brain (contrast enhanced) for the same.
4)Dystonia-Tongue Dystonia can be a possibility. But, we will have to wait and watch for the same. If no improvement occurs with time, it will have to be given a consideration. Other causes mentioned above have to be ruled out first.
Symptoms in toes appear just to be anxiety related.
If you have any further questions,please be in follow-up else,please close the thread and rate it.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Vaishalee Punj
Would you mind describing the prognosis for tongue dystonia? Is it progressive?
Brief Answer:
Dystonia has variable prognosis.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
Though,Dystonia is down the list as a cause here.But still,here follows the answer to your query-
Dystonia has variable prognosis.It may be progressive in some,while relatively static in others.It may respond to medicines in some and may not in others.
Prognosis also depends on the cause.If it is a primary dystonia,it can have variable prognosis as I explained above.
However,if it is secondary to some of the neurodegenerative diseases,it is mostly progressive.Neurodegenerative diseases like Wilson's disease,Neurodegeneration with brain iron accumulation,Neuroferritinopathies,Neuroacanthocytosis and many others may cause it.MRI Brain can provide a clue to some of the secondary causes.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.Your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
Dystonia has variable prognosis.
Detailed Answer:
Hi XXXX,
Thanks for being in follow-up.
Though,Dystonia is down the list as a cause here.But still,here follows the answer to your query-
Dystonia has variable prognosis.It may be progressive in some,while relatively static in others.It may respond to medicines in some and may not in others.
Prognosis also depends on the cause.If it is a primary dystonia,it can have variable prognosis as I explained above.
However,if it is secondary to some of the neurodegenerative diseases,it is mostly progressive.Neurodegenerative diseases like Wilson's disease,Neurodegeneration with brain iron accumulation,Neuroferritinopathies,Neuroacanthocytosis and many others may cause it.MRI Brain can provide a clue to some of the secondary causes.
Hope I have answered your query.If you have some follow-up questions,I shall be glad to answer else,please close the thread-rate it and write a review.Your rating will be of help to me.
Dr.Ajay Panwar,
MD,DM(Neurology)
Above answer was peer-reviewed by :
Dr. Pradeep Vitta
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