Differential Diagnosis for Slurring Speech
- Single most likely diagnosis
- Stroke or Transient Ischemic Attack (TIA): This is often the first consideration due to the potential for acute onset and the serious implications of missing such a diagnosis. Slurring of speech (dysarthria) can be a presenting symptom of a stroke, particularly if it affects areas of the brain responsible for speech and language.
- Other Likely diagnoses
- Intoxication (alcohol or drugs): Substance use can impair motor control, leading to slurred speech. This is a common and often reversible cause.
- Neurodegenerative diseases (e.g., Parkinson's disease, multiple sclerosis): These conditions can cause progressive damage to parts of the brain that control speech, leading to slurring.
- Medication side effects: Certain medications, such as sedatives, antidepressants, and antihistamines, can cause slurred speech as a side effect.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed)
- Brain tumor: Although less common, a brain tumor pressing on areas responsible for speech can cause slurring. Early detection is crucial for treatment.
- Meningitis or encephalitis: Infections of the brain and its membranes can present with a variety of symptoms, including slurred speech, and require prompt medical attention.
- Status epilepticus: Prolonged or recurrent seizures can cause confusion, altered mental status, and speech difficulties, including slurring.
- Rare diagnoses
- Amyotrophic lateral sclerosis (ALS): A progressive neurological disease that affects nerve cells in the brain and spinal cord, leading to loss of muscle control, including the muscles used for speech.
- Myasthenia gravis: An autoimmune disorder that can cause muscle weakness, including the muscles involved in speech production, leading to slurred speech.
- Huntington's disease: A rare, inherited disorder that causes progressive damage to the brain, affecting movement, cognition, and psychiatric aspects, and can include speech difficulties.