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Q. I have speech problems, dizziness, and headaches after being hit on my head. Please help.

Answered by
Dr. Hitesh Kumar
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 28, 2021

Hi doctor,

I think I might be suffering from post-concussion syndrome. I was punched quite aggressively on the left side of my head seven months before and have never felt the same since. My symptoms are tension headaches, dizziness, speech problems, and trouble thinking and concentration. I do not feel right since the injury, and I find speaking with people and taking part in conversations quite an effort. Speaking does not come as easy and smooth as it used to be before, but I do feel as though things are getting a bit better. I want to know if speech problems can arise from post-concussion syndrome? I hope you can give me some more information about the condition. Thanks.

#

Hi,

Welcome to icliniq.com.

I would like to know some further details about your symptoms.

1. What kind of injury or hitting happened on your left side of the head?

2. Did you become unconscious after the incident?

3. Had you developed vomiting or weakness of any side limbs after the injury?

4. Did you have any seizures or fits after the injury?

5. Did you undergo any CT (computed tomography) of the head or MRI (magnetic resonance imaging) of the brain after the injury? If yes, please attach the reports and, if possible, also send images.

6. What is the exact speech problem you have? Please describe it in detail. For example, do you have altered tone or prosody, or hoarseness? Do you stammer while speaking? Do you take time to think before speaking anything? Does speech problem always happen while speaking? Or is it intermittent? If intermittent, have you noticed in which situation the problem is more? Have other family members or friends noticed your change in speech pattern, or only you perceive it?

7. Are you already on medications? If yes, please tell the details of the medicines with their dosage and timing.

The post-concussion syndrome usually does not cause speech problems directly (as speech areas of the brain are preserved in injuries like a concussion). Still, there may be associated anxiety or post-traumatic stress and psychogenic, which may lead to lack of concentration and low volume speech. Patients may find difficulty in word-finding while talking with someone. But can sing a song fluently.

Due to psychogenic factors with a history of minor head injury, frequently such symptoms are wrongly labeled as post-concussion syndrome. I hope this helps.


Investigations to be done:

T3 (triiodothyronine), T4 (tetraiodothyronine), TSH (thyroid-stimulating hormone), serum vitamin B12, serum vitamin D3, and
MRI of the brain.

Treatment plan:

A clinical examination is needed to see what kind of speech abnormality is present. After ruling out brain structural abnormality or local nasal or laryngeal cause, detailed psychoanalysis is recommended, and based on that, some medications, psychotherapy, and speech therapy may be helpful.

Regarding follow up:

Revert with the above-mentioned detailed information and send investigations and medications in attachment for better understanding and further judgment.

Hi doctor,

Thanks for the reply.

Unfortunately, I was punched by someone from behind on the left side of my head—only one hit. I was not unconscious after the incident, but I felt confused and felt like I was in a haze. No vomiting or weakness of limbs after the injury. No seizures or fits after the injury. I did not have had a scan or anything. I saw the doctor, and he did some tests on me and told me that he did not find any severe problems. Speech problems are mild. It seems effortful and does not come as easy and smooth as before the injury. I have difficulty finding and thinking of the right words sometimes, and my sentences do not flow as easily as they used to before the injury. I find myself going blank sometimes, trying to think of a word, but this does not happen often. I have difficulty pronouncing words right sometimes, and I might pronounce a word well once but not another time. It feels as though my mouth comes to a stop as I am speaking. Starting and carrying on conversations does not come as easily to me as before. I find it hard to keep up with conversations in a busy environment with many people around. My parents have told me that they do not notice my speech problems. But I feel them myself, and I know that I cannot speak and talk to people as easily as I could before. My speech seems a lot better when I am reading a piece of writing, and yes, I can sing a song fluently. I do feel, maybe, things have been getting a bit better over the last few weeks, but I am far from being 100%. Currently, I am not on any medications.

#

Hi,

Welcome back to icliniq.com.

As per your information, it seems that the hit on your head was minor, with no loss of consciousness or vomiting, or limb weakness. Such a minor head hit does not seem to cause concussion injury. And your speech difficulty (perceived by you, not noticed by others) may be psychogenic (maybe anxiety) and not due to a head hit. I would suggest you consult a psychiatrist or psychologist for detailed psychoanalysis, and according to that, you may need psychotherapy, medicines, and speech therapy. Also, I suggest few investigations to rule out some organic things too.


Investigations to be done:

MRI of the brain, ECG (electrocardiography),
T3, T4, TSH, and vitamin B12.

Preventive measures:

You can try jogging daily for 30 to 40 minutes in the morning or yoga and meditation.

Regarding follow up:

You can revert with suggested investigation reports and psychiatrist opinion.

Hi doctor,

Thanks for the reply.

Because of my mild speech problems, they are most probably not apraxia, aphasia, or dysarthria. Would that be true? I have been having some trouble with my jaw, so could that interfere with my speech?

#

Hi,

Welcome back to icliniq.com.

As per your description, you can speak fluently while reading and singing, and other people notice no change in your speech while talking to you. That does not look like aphasia. Apraxia are of many types, cannot be judged by chat messages. To look or rule out an organic etiology, those tests were suggested. If reports come out normal and you still feel that you have a speech problem, I suggest you go for physical consultation with a neurologist, speech therapist, or psychiatrist. Thanks.


Regarding follow up:

Revert with suggested investigation reports.


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