OpenHealth Q&A

Neurological Issues Linked to Coordination Difficulties and Speech Impairment

I'm a 23-year-old Italian woman, standing at 160 cm and weighing 57 kg. I steer clear of alcohol, cigarettes, and illicit drugs. Throughout my life, particularly since elementary school, I have experienced strange "episodes" characterized by impaired coordination and slurred speech. These episodes typically begin with a vague sensation that signals their onset, followed shortly by noticeable issues with my coordination and speech clarity. Regarding coordination, initiating movement in my arms and legs is not the problem; however, controlling these movements proves to be challenging. It’s not a matter of spasms or uncontrolled actions. For instance, while I’m right-handed, my writing during an episode resembles that of someone using their left hand. Attempts to move can make me feel unstable, prompting me to remain still until the episode subsides, which usually takes between five to ten minutes. Even maintaining balance while standing can be difficult during these moments. As for my speech, I am able to produce and comprehend language without difficulty. I can communicate my thoughts and understand questions, but my tongue feels somewhat lethargic. To articulate clearly, I must focus intently and enunciate the words at a slower pace. The majority of these episodes transpired during physical exertion—mainly during gym classes, but there have been instances when I experienced them after getting off the bus and walking home. There was a notable episode that occurred in class while we were reading aloud from our homework; my anxiety triggered the episode. Additionally, a few have arisen just before meals. In November 2024, while I was ice skating, I began to feel the same sensation again. I paused, thinking the episode had passed, but after continuing to skate, I felt the sensation return. I left the rink to wait it out while seated, but this time the symptoms did not subside. I remained sitting for about an hour, and when I attempted to stand, my core and leg muscles cramped for the first time, nearly causing me to fall. Staff at the rink summoned an ambulance, and I was taken to the hospital where several tests were performed: - **CT Angiography** with and without contrast for suspected stroke: Results were normal. - **Neurological examination**: All findings were within normal limits. - **ECG**: Indicated sinus tachycardia, but I was emotional in the ER, so this might have affected the result. They administered Diazepam (one dose), which effectively concluded the episode, which had lasted roughly five hours at that point. - **EEG** examinations: All results normal. - **EEG with sleep deprivation**: Showed slight irregularities. - **Brain and brainstem MRI/MRA** with and without contrast: Results were normal. I received a potential diagnosis that led to a prescription for carbamazepine at a dosage of 200 mg daily, which appears to be effective, as I've not experienced any new episodes since starting the medication. While I don't yet have a conclusive diagnosis, I remain receptive to all suggestions as I seek to understand my condition better. I've endeavored to convey the medical terminology and details as accurately as I could!

Answers (1)

7/27/2025, 11:10:42 PM

OpenHealth AI

Thank you for sharing your detailed experience. It sounds like you've been through a lot, and it's understandable to seek clarity regarding your symptoms and their impact on your life. From what you've described, your episodes involve impaired coordination and speech difficulties, which seem to be influenced by physical exertion and anxiety.

Summary of Main Points:

1. Episode Characteristics: You experience episodes of impaired coordination and slurred speech that last approximately 5-10 minutes, primarily during physical exertion or occasionally accompanied by anxiety.
2. Medical Evaluations: Comprehensive tests like brain MRI and EEG have yielded normal results, and you’ve shown improvement on carbamazepine medication.
3. Ongoing Concerns: You are looking for further understanding and management strategies regarding your condition.

Explanation:

Your episodes are quite complex, and the fact that you've undergone thorough testing with normal results provides some reassurance. The effectiveness of carbamazepine in reducing your episodes is a positive sign, suggesting that the symptoms may be related to a condition that responds to this medication. While the exact cause of your symptoms is still under investigation, it is essential to continue monitoring your condition with your healthcare provider.

Next Steps:

1. Symptom Diary: Maintain a diary of your episodes, noting the timing, triggers (like physical activity, anxiety, time of day, etc.), duration, and any preceding sensations. This can help you and your healthcare provider identify patterns and potential triggers.

2. Medication Management: Continue taking your prescribed carbamazepine as directed. Discuss any side effects or concerns with your healthcare provider, especially if you experience changes in your symptoms.

3. Lifestyle Adjustments:

   • Hydration and Nutrition: Ensure you are well-hydrated and maintain a balanced diet, as dehydration and low blood sugar can affect coordination and energy levels.
   • Stress Management: Engage in stress-reducing activities such as mindfulness, yoga, or deep-breathing exercises. These may help reduce the frequency of episodes triggered by anxiety.

4. Physical Activity: Consider incorporating light, non-exhaustive activities that promote coordination and strength—such as walking or stretching—instead of high-intensity workouts, especially if you notice that physical exertion triggers your episodes.

5. Regular Follow-Up: Schedule follow-up appointments with your neurologist or healthcare provider to discuss your symptoms, the effectiveness of your medication, and any new developments.

6. Support Network: Share your experiences with supportive friends or family members. Sometimes, connecting with others who have similar experiences can provide comfort and helpful strategies.

It’s important to recognize that while unexplained symptoms can be frustrating and alarming, you are taking the correct steps by seeking information and following through with medical advice. Please continue to communicate openly with your healthcare provider about how you're feeling, both physically and emotionally. If you have any further questions or specific concerns, feel free to reach out for more tailored guidance.