Speech impairment (adult)

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Brain

Language impairment; Impairment of speech; Inability to speak; Aphasia; Dysarthria; Slurred speech; Dysphasia

For dysarthria, speaking slowly is encouraged, and the use of hand gestures, when necessary, is recommended. Family and friends need to provide plenty of time for those afflicted with the disorder to express themselves. Medications that are causing the problem should be stopped, if possible. Use of alcohol should be minimized.

For aphasia, family members may need to provide frequent orientation reminders, such as what day it is, because disorientation and confusion often follow the onset of aphasia.

A relaxed, calm environment where external stimuli are kept to a minimum is important.

Speak in a normal tone of voice (this condition is not a hearing or emotional problem), use simple phrases to avoid misunderstandings, and don't assume that the affected person understands. Frustration, profanity, and depression are typical responses in people suffering from aphasia.

Provide communication aids, if possible, depending on the particular person and condition.

• If impairment or loss of communication comes on suddenly, call your health care provider immediately.
• If there is any unexplained impairment of speech or written language, call your provider.

The health care provider will take a medical history and perform a physical examination. The medical history may require the assistance of family or friends.

Medical history questions documenting speech impairment may include the following:

• When did it develop?
• Did it develop suddenly?
• Is there a problem with clearly pronouncing words (dysarthria)?
• Is there a problem understanding speech?
• Is there a problem expressing thoughts through speech?
• Is there a problem understanding writing?
• Is there a problem expressing thoughts through writing?
• Has there been a recent head injury?
• Are there problems with dentures?
• What medications are used?
• Is there recent or former heavy alcohol use?
• What other symptoms are also present?

The physical examination will include a detailed evaluation of brain function.

Diagnostic tests that may be performed include the following:

• CT scan of the head
• MRI of the head
• EEG
• X-rays of the skull
• Blood tests
• Urine tests
• Lumbar puncture
• MR angiography
• Cerebral angiography

Review Date: 09/07/2006
Reviewed By: Kenneth Gross, M.D., Neurology, North Miami, FL. Review provided by VeriMed Healthcare Network.