What's going on

[enlightenedfool]

I have had an interesting problem in the last year or so, that seems to be getting worse.

I used to be very articulate, but it is becomeing increasingly difficult for me to speak, both the place my thoughts into words and make the physical notions of articulating my speech, though not so much with typing. Sometimes it has gotten so bad that I will just say a long stream like"and...well...i don't know...you know...yeah" and the like, then just giving up. It's as if something is blocking my words or as if my tongue stopped listening to my brain. Still, it's something that comes and goes.

I'm 19, and have a diagnosis of tourette syndrome (not sure if this could be related).

Does anyone know what this could be? Could this be a sign of a brain injury? Is there anything I can do?

[caregiver222]

The first thing you should do is to rule out a structural abnormality, a tumor, or benign growth.

Before going to a language or speech therapist you need to rule out a physical issue.

Fortunately we now have the MRI and the MRA (with dye contrast) to effectively rule out this kind of a problem.

A neurologist will rule out an autoimmune disease that may be attacking the brain.

In terms of differential diagnosis there are people who have this sort of problem all their lives. Then there are those who develop the problem. The change from being normal to having a problem suggests a degenerative process.

Recent literature suggests there may be a viral infection at work. A virus that creates an autoimmune problem. Scientific American reviewed this problem recently in an issue on Alzheimer's. The study is relevant. It turns out there are several kinds of virus that, when activated, destroy cognitive ability. The key issue is what turns the replication process on? Nobody is sure, but there is often a co-factor, such as exposure to Herpes. The Herpes itself does not cause the problem, but triggers replication of ofther viral entities.

My suspicians narrow down to two etiologies.

(1) A structural abnormality
(2) A degenerative neurological disease

I am dubious that a "stressful incident" caused this problem.

A speech and language therapist will help, but the idea is to stop this process in it's tracks.

[Dr. A. Srivastava]

Hi, Thank you for your question. Stammering of voice is fairly common with adults after any stressful incident and could be associated with tourette syndrome. In general, the outlook is very good with about 80 percent, as it will be resolving completely. However, the prognosis depends upon many different factors. The best thing to do would be to see your Doctor first and request that you need to be referred to a speech and language therapist. Hope this helps.