Dystextia

What would you do if you received strange, nonsensical text messages from an older friend or loved one? A group of researchers are calling this phenomenon “dystextia,” and they say it may be a sign that the person is having, or has had, a stroke.

Their case study, presented at the March 2013 meeting of the American Academy of Neurology, involves the case of a 40-year-old man who was in Detroit on business. Around midnight, the man awoke disoriented, and fired off a series of text messages to his wife that she later characterized as “disjointed and incomprehensible.”

The next day at the hospital, the man seemed normal. He answered correctly when given a routine speaking and language comprehension test neurologists use to diagnose stroke-induced aphasia, or language disruption.

But when the doctor handed him a smartphone and asked him to type, “The doctor needs a new blackberry,” the patient faltered. Instead he typed, “The Doctor nddds a new bb.” When reading it back, he didn’t recognize any misspellings and said it was correct. An acute ischemic stroke was later confirmed by a CT scan and MRI of the man's brain.

Neurologist Omran Kaskar, M.D., lead author of the study, says this case illustrates how dyslexic texting, or "dystextia," can provide an important test of written-language impairment in situations in which speaking and comprehension abilities seem otherwise normal.

“Besides the time-honored tests we use to determine aphasia in diagnosing stroke, checking for dystextia may well become a vital tool in making such a determination,” Kaskar said in a press release.

Dystextia is a classic example of expressive language aphasia, which affects how language is perceived, spoken, read, and written. Aphasia results from a blockage of blood flow to the language centers of the brain. Without a constant supply of nutrient-rich blood, parts of the brain can “die,” causing functional language impairment.

Why Minutes Matter: Time Means Brain Cells

When a stroke strikes, every minute counts.

“The sooner a stroke is detected and treated, the better function and prognosis a patient will have,” says Kaskar. Proven medical interventions for an acute stroke include injecting clot-busting medicines that can stop brain damage in its tracks.

It's also important for doctors to determine exactly when the stroke occurred. The date and time stamp on text messages may help if the patient texted someone around the time of symptom onset.

“Time is brain. There is a very short window (approximately three to 4.5 hours) where a neurologist can administer these medications,” Kaskar adds.

Stroke by the Numbers

Based on Centers for Disease Control (CDC) health data for 2011, stroke is the leading cause of serious, long-term disability and the fourth leading cause of death in the U.S. Common stroke risk factors include obesity, smoking, high blood pressure, diabetes, excessive drinking, and an inactive lifestyle.

Although the risk of stroke increases with age, a stroke can occur at any time. According to 2009 CDC statistics, 34 percent of hospitalized stroke victims were under the age of 65.

In addition to language deficits, common symptoms include numbness in the face or limbs, confusion, vision problems, dizziness, loss of balance, or severe headache (in the case of hemorrhagic, or bleeding, stroke).

The number of text messages sent daily worldwide is estimated at 75 billion. Kaskar says physicians should make their patients aware of dystextia as a reliable detector of stroke.

“Since texting is such a common form of communication, any disjointed, nonsensical texts may be a warning sign, especially if the person has risk factors for stroke,” he says.

Spread the Word

Strokes can occur anytime, anywhere—and rapid treatment is vital. If you receive a garbled text from a loved one and sense that something isn’t right, acting fast can make a difference in the level of impairment they may suffer.

Kaskar says to immediately try to reach the person who sent the text. “If there is concern about stroke based on the person’s history or other symptoms, such as weakness, slurred speech, or numbness, don’t delay in getting them to the emergency room.”

The authors of the study say that checking for dystextia may become another important diagnostic tool for stroke, especially in patients who exhibit no other symptoms. As word about “dystextia” spreads among doctors, patients, and families, it may help stroke victims get the acute interventions they need.

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