My father's speech is unclear lately. Why?

Question

Hello doctor,

I am worried about my father. He is not able to speak clearly of late. He feels that his tongue has swollen. I have consulted many doctors, but they were unable to diagnose his disease. All his test reports are alright. There was no problem detected. But one doctor tells us that the muscles of his tongue are weak and that is the reason he is not able to speak clearly. What can I do for him? He is currently on CQ10, Rabixin, Seroxat CR, Rivotril, Sinemet, and Motilium.

Answer 1

Hello,

Welcome to icliniq.com.

Can you elaborate on the symptoms ? 1. How old is he? 2. Does he feel like there is something stuck in the throat? 3. Is there any change in voice or a hoarseness? 4.Is there any pain or difficulty in swallowing? 5. Is there any weight loss or loss of appetite? 6. Does he smoke? 7.Does he have an acidity problem? 8. Did he undergo gastrointestinal endoscopy or laryngoscopy anytime in the past? 9. Why is he taking Seroxat, Rivotril and Sinemet ? Do you have prescriptions for these? 10. When the problem of speech started, was it insiduous?Meaning to say, started slowly without him coming to know about it. Or did it start abruptly? 11. Are there time periods when his speech returns to normal and then worsens again? 12. Does he find any relief with medicines or steam etc? 13. Can you upload his test reports? When you provide all the details, it will be easier for us to arrive at a decisive diagnosis and suggest you the right treatment. With the information you have provided it is not possible to make any conclusions.

Answer 2

Hello,

Welcome back to icliniq.com.

He has a change of voice, as in hoarseness, as well as pain and difficulty while swallowing. So, we must do an upper gastrointestinal endoscopy or at least a laryngoscopy to check the condition of the voice producing area and the esophagus and stomach. Laryngoscopy will show the movement of the vocal cord, whether the movement is equal with phonation and respiration and if there is any abnormality with the vocal cord, sub glottis, epiglottis or pyriform sinus. An upper gastrointestinal endoscopy will check for a possibility of reflux issues. These two tests are essential before we come to any conclusion. There is no basis in taking medicines without an actual diagnosis and to have that, we need to have a look inside. A laryngoscopy will be done by an ENT specialist using an endoscope. The upper gastrointestinal endoscopy will be done by a gastro-specialist. Until the tests are done, I suggest you the following medicines: 1. Anti-inflammatory enzymes, a combination of Trypsin, Chymotrypsin, and Bromelain to be taken twice daily before meals. 2. Esomeprazole 40 mg taken twice daily, half an hour before meals. 3. Syrup Mucaine gel (Oxetacaine, Aluminium hydroxide and milk of magnesia), one teaspoon, taken after meals and at bed time. You are also advised to cut the intake of coffee, tea, spices and acidic food items. Do ask for further support if necessary. Hope your father gets well soon.