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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Should I Be Worried About The Speech Impediment For A Stroke Patient During Recovery?

My husband suffered a stroke about a year and a half ago. His speech was mainly affected. He improved much following speech therapy. Last November, he suffered a seizure which I hear is very common the first year following a stroke. He's been feeling very good lately, both physically and mentally. So much so that he overextended himself performing projects around our house and yard (for a couple of weeks). The other day he appeared confused and his speech isn't nearly as good as it had been. Are ups and downs common for stroke patients during recovery? Does he need to always "take it easy" even when he feels energetic? It's so disappointing to both of us. Want to keep a positive outlook about the future but, it's very difficult at times. My husband is very active by nature and "forgets" to take it slow.
Fri, 18 Sep 2015
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Cardiologist,  's  Response
Hello!

Thank you for asking on HCM!

I read carefully your question and understand your concern.

I would like to explain that some fluctuations may occur during recovery period.

But as you refer, he was doing well since his stroke. From the other hand an episode of confusion and speech problems raises high suspicions for a possible new small stroke (lacunar stroke) or a seizure.

Even a seizure, can be caused by a new stroke.

Is he taking any antiepilepsy drugs? Their overdosage could also cause a similar clinical scenario.

I recommend consulting with his GP for a careful physical examination, a brain MRI or CT scan and some lab blood tests ( complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, etc.), to rule in/out the possibility of a new brain ischemic event.

A brain EEG may be needed to exclude possible seizures. If he is taking any antiepileptic drug, you should measure their plasma levels (depending on the drug type).

Hope to have been helpful!

Best regards,

Dr. Iliri
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Should I Be Worried About The Speech Impediment For A Stroke Patient During Recovery?

Hello! Thank you for asking on HCM! I read carefully your question and understand your concern. I would like to explain that some fluctuations may occur during recovery period. But as you refer, he was doing well since his stroke. From the other hand an episode of confusion and speech problems raises high suspicions for a possible new small stroke (lacunar stroke) or a seizure. Even a seizure, can be caused by a new stroke. Is he taking any antiepilepsy drugs? Their overdosage could also cause a similar clinical scenario. I recommend consulting with his GP for a careful physical examination, a brain MRI or CT scan and some lab blood tests ( complete blood count, fasting glucose, kidney and liver function tests, blood electrolytes, etc.), to rule in/out the possibility of a new brain ischemic event. A brain EEG may be needed to exclude possible seizures. If he is taking any antiepileptic drug, you should measure their plasma levels (depending on the drug type). Hope to have been helpful! Best regards, Dr. Iliri