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Neurology (Expert Forum)
Could speech problems be all related to the MVA from 34 years ago or something new?
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Could speech problems be all related to the MVA from 34 years ago or something new?
by Graydove, May 25, 2007 12:00AM
When I was 12 I was in a MVA causing TBI and a 3 day Coma, I’m now 46
I was a charge nurse caring for 24 skilled need clients, a very stressful job. I started having headaches, then mild speech and writing difficulties. I had trouble concentrating and connecting things to the right time of day, I had trouble even giving medications at the correct time, I would look at my watch and then at the MAR and not be able to connect to the time it was.
03/21/07 I ended up in the ER at the local hospital having a CT and labs done. The next day I go and see my PCP. He tells me my speech resembles someone learning a new language. He wants an MRI done. I saw a neurologist; she didn’t have recent CT or MRI in her office. I have a copy of her notes: she refers to a CT I had a year ago when I was having some problems with one of my hands going numb. Anyhow the note refers to showing traumatic frontal lobe changes. I don’t know if this is from the damage done from the MVA or if it is more recent, this was not specified. She also describes my speech initially to be slightly slow and stilted and then changes to more of a child-like talk so that I would say "I flew over truck", "Naproxen all gone", "bottle say 75mg.". A month later I was able to get most of my speech and writing back to almost normal. I still find myself slipping at times with any increases in stress.
Is this stress, old TBI related or maybe both?
Will it ever go away completely?
What can I do about it?
I was a charge nurse caring for 24 skilled need clients, a very stressful job. I started having headaches, then mild speech and writing difficulties. I had trouble concentrating and connecting things to the right time of day, I had trouble even giving medications at the correct time, I would look at my watch and then at the MAR and not be able to connect to the time it was.
03/21/07 I ended up in the ER at the local hospital having a CT and labs done. The next day I go and see my PCP. He tells me my speech resembles someone learning a new language. He wants an MRI done. I saw a neurologist; she didn’t have recent CT or MRI in her office. I have a copy of her notes: she refers to a CT I had a year ago when I was having some problems with one of my hands going numb. Anyhow the note refers to showing traumatic frontal lobe changes. I don’t know if this is from the damage done from the MVA or if it is more recent, this was not specified. She also describes my speech initially to be slightly slow and stilted and then changes to more of a child-like talk so that I would say "I flew over truck", "Naproxen all gone", "bottle say 75mg.". A month later I was able to get most of my speech and writing back to almost normal. I still find myself slipping at times with any increases in stress.
Is this stress, old TBI related or maybe both?
Will it ever go away completely?
What can I do about it?
Doctor's Answer
by CCF-Neuro-M.D.-SH, Jun 23, 2007 12:00AM
First of all, keep in mind that I am unable to diagnose you because I am unable to examine you, this forum is for educational purposes.
Traumatic brain injury, especially from motor vehicle accidents, causes damage to the frontal lobes and sometimes the temporal lobes as well. This often leaves a scar that will be there for life. The functions of the damaged areas can often move to other adjacent areas, but can be more likely to fail if stressed. The most concerning possibility is that seizures can arise from the scar and cause focal frontal seizures that can also cause the symptoms that you describe, including confusion, disorientation, headaches and speech problems. I would recommend that you get an EEG (brain wave test) to evaluate for seizures. It would be best to get the EEG when you are having one of your confusion episodes, but if that is not possible I would recommend a 2 hour sleep deprived test. If you continue to have repeated episodes like you described I would recommend a trial on an anti-epileptic drug (such as Topamax) that will work for seizures and migraine prevention as well.
I hope this has been helpful.
Traumatic brain injury, especially from motor vehicle accidents, causes damage to the frontal lobes and sometimes the temporal lobes as well. This often leaves a scar that will be there for life. The functions of the damaged areas can often move to other adjacent areas, but can be more likely to fail if stressed. The most concerning possibility is that seizures can arise from the scar and cause focal frontal seizures that can also cause the symptoms that you describe, including confusion, disorientation, headaches and speech problems. I would recommend that you get an EEG (brain wave test) to evaluate for seizures. It would be best to get the EEG when you are having one of your confusion episodes, but if that is not possible I would recommend a 2 hour sleep deprived test. If you continue to have repeated episodes like you described I would recommend a trial on an anti-epileptic drug (such as Topamax) that will work for seizures and migraine prevention as well.
I hope this has been helpful.
Some years ago after psychological testing, a clinical psychologist told me that a number of my problems were consistent with having had some early brain damage to the left hemisphere. Since I have never had my brain scanned, I cannot confirm that hypothesis however it is certainly not impossible given as I nearly died from pneumonia when I was 7 months old and if the lack of oxygen didn't get me, then the heavy doses of streptomycin that were given back then could have done.
What does happen to me under situations of extreme stress and overload is that my speech fades, to begin with I will stutter and after that my speech will become more and more telegraphic in that I lose the ability to use conventional grammar, after that it becomes quite aphasic in that I could not even write down the right words to use as I am in a land of picture language only.
This is a frightening situation to be in when it happens, because of the difficulties in communicating, often when communication is important, however it is not one that concerns me unduly as it is an old problem indeed that goes way back to my childhood.
Can this be some kind of stroke, but not leave big, effect, but I think each time have more loss and not get as much back each time.
I 46 have had trouble with BP go to high sometimes, but not on Antihypertensive meds now, not been on before either.
Thank you Sheila
I am dyslexic so have to admit my command of grammar is not all that great most times anyway, but I would reckon that whenever you have some underlying difficulty with anything, stress is going to make it even harder to do, also fatigue can impact that.