What could cause a sudden onset of slurred speech and general brain slowness?

September 17, 2010 11:08 AM

What could cause a sudden onset of slurred speech and general brain slowness?

While I was studying this morning I found myself unable to pronounce the words "cellular," "carbohydrate," "glycogen," etc without slurring my speech...both out loud and in my head. I also noticed my thought process was unusually slow, for example I'd be in the middle of a sentence, then need to pause before being able to continue said sentence. "Glycogen is glucose ... ... ... linked together," again both in my head and aloud. Basically it was like I was drunk.

When speaking out loud, I felt a pressure in my throat whenever I spoke. My memory was unaffected.

This lasted about an hour then everything cleared up, though in the half hour it took me to write this it returned.

Possibly relevant details:

- Blurry vision and and not being able to glance from one thing to another without it hurting has been an on and off problem for me. My vision was extremely blurry and hurty last night, but I chalked it up to too much caffeine and it's at the normal slightly-blurriness now.
- Took 3 pills of 100mg wellbutrin instead of the normal one pill of 300mg since I ran out.
- Started taking amino acids yesterday.
- On Zoloft, wellbutrin, amino acids, and prenatal pills for anemia.
- No muscle weakness or other symptoms of stroke.
- Nausea, but that's a pretty normal thing for me.
- No alcohol or illicit drug use
- Have been headachy for the past week

I haven't seen a doctor because I've gone there for a few problems that I thought were a Big Deal, and during the visit he said it was basically nothing to worry about and/or had a simple solution. I don't want to be the person who sees the doc for every little thing because I'm afraid if I do that I'll be the "patient who cried wolf" and if something -is- serious down the line it'll be overlooked.

posted by biochemist to health & fitness (36 answers total)

Obvious, but: are you getting enough sleep?
posted by naju at 11:12 AM on September 17, 2010

Listen, I hate to be that alarmist guy on the internet, but several of these symptoms are signs of a stroke. I don't know whether the fact that it's coming and going says anything, but with brain stuff like this, it's sometimes best not to take chances.
posted by Dasein at 11:16 AM on September 17, 2010 [8 favorites]

That happens to me if I skip meals or if I don't eat a healthy diet (although I don't get the throat-pressure thing, my mind just stops working and my speech slurs).
posted by kataclysm at 11:16 AM on September 17, 2010

Get thee to a doctor. PRONTO. (Or, better yet, get someone else to take you.)

You may not have all the symptoms of stroke, but you've got enough that I'm seriously worried about you.

Go get this checked out, right now.
posted by ocherdraco at 11:23 AM on September 17, 2010 [3 favorites]

The symptoms are consistent with increased intercranial pressure, and *may* indicate a brain tumour.

Doctor.

Just putting it out there.
posted by Biru at 11:24 AM on September 17, 2010

Also, it is not a problem to go to the doctor with something you think might be wrong only to learn that it's nothing and/or normal. That's part of the job: a diagnosis of "well" is still a diagnosis.
posted by ocherdraco at 11:25 AM on September 17, 2010 [2 favorites]

I've had migraines that have affected my speech, vision, ability to read, etc.. I'd see an MD.
posted by Carbolic at 11:26 AM on September 17, 2010 [1 favorite]

Are you a native English speaker? I am not, and my speech gets noticeably worse when I am tired/drunk/had too much caffeine/upset.
posted by halogen at 11:29 AM on September 17, 2010

Yup, get yourself to a doctor, pronto!

This is slowly becoming my mantra around these parts: DO NOT FUCK WITH YOUR HEAD.

GO! Better to be safe than sorry.

Background - me being a dumbass almost caused myself to have a stroke. My original post is here.
posted by cgg at 11:30 AM on September 17, 2010 [3 favorites]

These symptoms could indicate a serious problem. Doctor, NOW.
posted by Decani at 11:35 AM on September 17, 2010

Took 3 pills of 100mg wellbutrin instead of the normal one pill of 300mg since I ran out.

I'm no pharmacist, but I wonder if that's really equivalent. Are the pills controlled-release or sustained-release? (My Google-fu suggests that is at least sometimes the case, but of course I don't know if they're all like that.) I'd imagine that taking three 100mg pills, because of the much greater surface area, would not produce the same effects as one 300mg.

So you might have unintentionally ODed, or caused the level in your bloodstream to spike in a way that's much different than your normal dosage.

That might be worth mentioning to your doc, presumably whoever prescribed you the Wellbutrin would be the person to call.
posted by Kadin2048 at 11:36 AM on September 17, 2010 [1 favorite]

Sounds like stress, fatigue, and possible migraine to me.
posted by Kafkaesque at 11:38 AM on September 17, 2010

I had most of these symptoms when I was on Wellbutrin and doubled the dose as instructed by my doctor. It was TERRIFYING. Call the prescribing doctor and explain whats happening and tell them about the medication substitution.
posted by elsietheeel at 11:44 AM on September 17, 2010

Wellbutrin is also well-known for having problems with generic vs. brand formulations re: absorption rates. If your 100mg pills were generics, or a different generic than your 300mg are, it might cause problems. Just going from one pill to three probably has an effect on absorption anyway.

Regardless. Go to the doctor. Don't fuck around when it comes to your brain.
posted by cosmic osmo at 11:52 AM on September 17, 2010

Sounds consistent with migraine to me, but I'm just some weirdo on the internet. Please see your GP ASAP.
posted by goshling at 12:11 PM on September 17, 2010

I hope you're not reading this because you are in the ER getting checked for stroke. If not, do that.
posted by cross_impact at 12:11 PM on September 17, 2010

Okay, imagine three scenarios.

1) You only go to the doctor exactly when there is something "serious" medically wrong with you. This is a preposterous ideal which requires you to effectively *be* a skilled diagnostician.

If you rule out 1), you are left with:

2) you go to the doctor for things which seem like they merit the doctor's attention, and 19 times out of 20, are told it's fine.

3) you refrain from going to the doctor for things which seem like they merit the doctor's attention, and, one time out of twenty, you are NOT told that it's NOT fine.

Which is better, 2 or 3? Which do you think the doctor prefers?

Not to put too fine a point on it, the doc is paid for her time, proximally or distally by YOU (even if the twists and turns of how you're actually paying would make an economist blanch.)

GO TO THE DOCTOR.
posted by endless_forms at 12:14 PM on September 17, 2010 [2 favorites]

Since many are crying "Stroke," I'll suggest another scary "s"-word: "Seizure." Larger doses of Wellbutrin (which, it seems could happen with the substitution you did) can cause them, and seizures need not be physically violent. The good news is that unlike a stroke, a drug-induced seizure doesn't necessarily imply physical damage.

Still, I'd be going to a doctor.
posted by Good Brain at 12:59 PM on September 17, 2010 [4 favorites]

I don't like being "that worst case scenario guy" but my father experienced pronunciation difficulties very much as you've described. He went to his GP a few times and his symptoms were eventually dismissed as psychosomatic. He finally had a seizure about 9 months later and was diagnosed with a brain tumour. Coincidentally, his GP was diagnosed with exactly the same condition less than a year after that.

Now is not the time to worry about looking like a hypocondriac. Demand an MRI. Demand to see a specialist.
posted by bonobothegreat at 1:13 PM on September 17, 2010 [1 favorite]

What everyone else said about getting to the doctor NOW. Also while you're there you should be sure when they take the history to list all the meds you are on - standard procedure - he should review. Wellbutrin AND Zoloft? I am not a doctor but I am surprised that one would be prescribed both at the same time?
posted by dudeman at 1:32 PM on September 17, 2010

Yes, you should get checked out any time you start slurring speech as that could indicate a stroke. Or a tumor. By my first thought was a little different.

Note that I am not a doctor and even if I were a doctor I would not be diagnosing you.

Blurry vision and and not being able to glance from one thing to another without it hurting has been an on and off problem for me. My vision was extremely blurry and hurty last night

This sounds like optic neuritis to me. When you glance quickly from side to side with your eyes closed would you see sparky things or a ring of light? Optic neuritis plus remitting aphasia could be multiple sclerosis. I don't suppose you're a woman in your early 20s who grew up north of the mason-dixon line?

In any case, if you're suddenly slurring speech you need to get checked out even if it is just some weird infection or whatever.
posted by Justinian at 1:45 PM on September 17, 2010

I looked at your other questions just to see if you had posted your age and stuff. Hope that's okay. It looks like you are, indeed, a young woman in your early 20s from Ohio. So yeah I'd probably want to go talk to the doctor and make sure to mention the vision problems as well as the aphasia and headaches.
posted by Justinian at 1:50 PM on September 17, 2010

Wellbutrin AND Zoloft? I am not a doctor but I am surprised that one would be prescribed both at the same time?

Wellbutrin is sometimes prescribed to offset side effects of other anti-depressents. With the weird dosage yesterday, though, maybe you should get checked out for serotonin syndrome, yeah?
posted by lunalaguna at 2:27 PM on September 17, 2010

Good Brain (eponysterical?) is right. The Wellbutrin could have caused some simple partial seizures. I hope you're at the doctor getting checked out.
posted by elsietheeel at 2:29 PM on September 17, 2010

IANAD.

Nthing that you should get yourself checked out, perhaps by a neurologist. It very well may be tied to the Wellbutrin, but I do want to offer up my wife's experience as another data point:

Two years ago, my wife, ~age 40, had a very serious seizure whose root cause was ultimately diagnosed to be an arteriovenous malformation, or AVM (Google Health link). This was a congenital condition that remained dormant for many years. Once it began to present symptoms, she lived with them and shrugged them off for about 10 years before her brain's plumbing finally overruled her denial, and in those 10 years, her symptoms were similar to yours: brief periods during which she experienced occasional slurred speech/difficulty finding the correct word to use, odd head-achy stuff, etc. She would go months without a problem and then experience some odd stuff for seconds or minutes. Afterwards, she was quick to shrug off these experiences as "too much coffee", "not enough coffee", being dehydrated, etc.

I am not suggesting that an AVM is the cause of what you are experiencing, only relaying that my wife experienced some similar symptoms and that they turned out to be caused by a serious condition, one that did not show up on a CT scan but did show up on a MRI. Once properly diagnosed it required some delicate surgery to correct. Thankfully, she's fine now.

Anyway, this is exactly the sort of thing you should take seriously. Your symptoms have a cause, and you need to see a doctor, (perhaps a neurologist) to determine that cause and take appropriate action to correct the underlying condition, whatever it may be. Please get yourself checked out, preferably by a doctor trained in assessing neurological issues.
posted by mosk at 2:57 PM on September 17, 2010

I don't know, but this is your head we're talking about. Why are you reading this and not at the doctor?

My dad started to have trouble spelling things, but he waited a good 10 days to go to the doctor, who diagnosed stroke and begged the powers-that-be for an emergency referral within 6 weeks. 5 months later, there was a knock at the door; it was the ambulance to take him to his first radiotherapy appointment. I explained to the paramedic that we were very busy preparing the house for his funeral that afternoon; he had died two weeks earlier.

I woke up one night to get a glass of water and found my vision obscured by a cascade of small x's. Then the world separated into little egg-carton compartments. It was a few minutes before I could even begin to see again. It turned out to be a trivial hallucination brought about by turning the light on suddenly.

My point is that you never can tell with this stuff. There's really no point asking us, it could be nothing or it could be a matter of life or death with no time to spare.
posted by tel3path at 3:00 PM on September 17, 2010

Nthing "see the doctor". Brain tumors can start out this way, and in the (small!) chance that that's the case, the prognosis is much much better the earlier it's caught and treated.
posted by roystgnr at 3:11 PM on September 17, 2010

My GP had an appointment open today so I went. I'll be having an MRI and echocardiogram next week, and in the meantime she suggested laying off the caffeine and calling the hospital if it happens again for more than a few minutes.

I mentioned that I had to be convinced to go and she said she's glad I went; and I'm glad I went to. So thanks MeFi!
posted by biochemist at 3:24 PM on September 17, 2010 [5 favorites]

Yay! I've got my fingers crossed that everything is well. I'm glad you went, too.
posted by ocherdraco at 3:30 PM on September 17, 2010

Hmm... I can add "wrong word choice" to my list of symptoms. I was writing an e-mail just now and managed to type "punishmeant" and "unrealistic" when I meant to say realistic. I noticed this earlier today but brushed it off. A good example is right here with the "to" instead of "too."

Full disclosure: I'm a grammar nazi so it's really unusual... I don't even notice the mistakes until I read back over what I typed.
posted by biochemist at 9:50 PM on September 17, 2010

biochemist, I think you should call the hospital. It's getting worse.
posted by tel3path at 5:50 AM on September 18, 2010

I'm not sure that's true. I know from personal experience and observation of others that when you're freaking out about something, stuff which you would normally not even notice will seem to take on major significance. Typing "unrealistic" for "realistic", for example, is the type of minor typo that we all make. This is not to say that the OP shouldn't call if she is concerned, but I don't think these typos are necessarily indicative of anything.
posted by Justinian at 10:30 AM on September 18, 2010

It's just that that is how my father's brain tumour progressed. Almost to the letter.

I felt uneasy about that, too, but I also pushed it out of my mind as the "type of minor typo that we all make". Except that he never did.

Normally I wouldn't be alarmist about this. I know I am being extremely alarmist. Most likely, if biochemist calls the hospital it will turn out to be nothing. It's just that what she's written strongly reminds me of my own bad experience. So even if nobody else would advise her to call under these circumstances, I would.

biochemist, if you feel bad about calling the hospital, explain that your crazy neurotic friend was raving and insisting about it and you called them just to calm me down. They don't have to know that your crazy neurotic friend exists only over teh interwebz.

Then they can tell you it's nothing, and I can go back to being all crazy and neurotic on my own behalf.
posted by tel3path at 10:47 AM on September 18, 2010

It's just that that is how my father's brain tumour progressed. Almost to the letter.

If the OP hadn't yet been to the doctor I would agree with you. But the OP is already scheduled for an MRI in less than a week. So right now they're obviously covering their bases in that regard; what the hospital is concerned about on an emergent basis is stroke or the like.
posted by Justinian at 12:33 PM on September 18, 2010

Fair comment. And they're not taking a leisurely approach to her care, either. I think things would have turned out differently for my father if he'd had an MRI within a week, rather than within months.
posted by tel3path at 1:04 PM on September 18, 2010

Any update, OP?
posted by mosk at 1:43 PM on October 15, 2010