HomeAnswersNeurologydiabetesWhat does it mean to have a sudden onset of slurred speech?

Why did my father develop slurred speech two days back?

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Answered by

Dr. Hitesh Kumar

Medically reviewed by

iCliniq medical review team

Published At June 29, 2017
Reviewed AtJanuary 31, 2024

Patient's Query

Hi doctor,

My 70 year old father has developed slurred speech from two days. He has diabetes, benign prostate hypertrophy, and history of vascular dementia. He does not have weakness, paralysis, or numbness. He does not have hypertension or any cardiac disease. He refused to do a computed tomography (CT) scan in the emergency room (ER). His blood test including coagulation profile and troponin were normal. His HbA1C is 6.8, and the electrocardiogram (ECG) was normal. Yesterday, the doctor started him on Aspirin 81 mg and Atorvastatin 40 mg. He is on Risperidone 1 mg more than 10 years without an obvious diagnosis. The psychiatrist started him on this medicine because of an acute psychotic disorder. An magnetic resonance imaging (MRI) was done last year, and I will upload the report. What should we do about the slurred speech?

Answered by Dr. Hitesh Kumar

Hello,

Welcome to icliniq.com. In a patient, having risk factors, like diabetes mellitus and acute onset slurring of speech, it raises the possibility of developing an acute stroke. Though there may be other causes too. I would suggest undergoing the following tests: 1. Magnetic resonance imaging (MRI) of the brain orNCCT (non-contrast computed tomography) of the head. 2. CPK (creatinine phosphokinase). 3. Serum sodium. The possible differential diagnoses are: 1. Acute stroke. 2. Neuroleptic malignant syndrome. 3. Worsening of psychosis and acute delirium. The previous MRI with past clinical history (attachment removed to protect patient identity), are suggestive of dementia. If the patient is not cooperative, then NCCT head must be done to rule out any bleeding inside the brain.

Patient's Query

Thank you doctor,

We took my father to an emergency room (ER) again today to get a computed tomography (CT) scan. He did the CT scan, and an internal medicine physician saw the CT film. He said there is no stroke and no hemorrhage. I have uploaded the results of the blood test for your opinion.

Answered by Dr. Hitesh Kumar

Hello,

Welcome back to icliniq.com. The attached reports (attachment removed to protect patient identity) are not clear. You need to upload them again. As you mention that there is no hemorrhage or bleeding in the CT scan, then tablet Aspirin and other medicines can be continued. Buta normal CT scan does not rule out ischemic stroke. As small ischemic stroke can be missed in a CT, it will require an MRI of the brain to pick it.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Hitesh Kumar
Dr. Hitesh Kumar

Neurology

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