What Causes Slurred Speech With Normal EEG And CT Scan?

Brief Answer:
Please provide more details

Detailed Answer:
Hello,

Before proceeding to discussing I would like to summarise the problem. Your father is 70 years old male and since last one year he has started talking irrelevantly in episodes. All investigations like EEG and CT-scan came normal. He is normotensive and has no significant past medical history. He has been prescribed Donepezil sustained release (11.5), Fluvoxamine 50 mg and Olanzapine 2.5 (?).

Before going to details I would like to know few things-

How his symptoms started, like acutely or over a period of time?

Whether there is any associated history of chronic alcohol intake, head trauma or seizures?

Whether he is showing symptoms like forgetfulness, lack of recognition of faces, difficulty in carrying out tasks, inability to follow normal routine?

If there are other mood symptoms apart from irritability like crying spells, decreased social interaction, ideas of hopelessness, worthlessness?

How is his sleep? If he is able to do his personal daily routine by himself or need assistance? If he demands food by own or you have to ask him for food?

If there are any other symptoms like tremors of hands, slurring of speech, change in walking?

Please provide me these details as per your convenience so that I can help you to go further in his management.

Thanks.

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Brief Answer:
Most likely due to age related dementia

Detailed Answer:
Hello again thanks for providing details

As there is no history of seizures, head trauma or any alcohol intake, no slurring of speech, tremors of hands or change in walking so we can rule out common neurological and organic causes.

Considering his age and symptoms like benign forgetfulness, persisting on thoughts along with gradually progressive episodic irrelevant speech could be due to early stage of dementia, though detailed evaluation is needed to confirm diagnosis.

Some times aggressive behaviour may be seen in such individuals because due to failure to carry out daily tasks or benign forgetfulness may result in aggression. He is currently on Donepezil sustained release tablet, fluvoxamine and olanzapine. Fluvoxamine has been added in his prescription for improvement in depressive symptoms and Olanzapine is added to decrease aggression. Donepezil is a cholinergic drug and this drug will halt his progression of dementia. He is on perfect doses of Donepezil.

Apart from donepezil, drugs like Memantin can also used in combination to donepezil to delay the progression. Herbal syrup like Mentate Syrup should be given to him This is a drug which is available without prescription so is safe to use.

As per my opinion drug like Sertraline can be added inspite of fluvoxamine in his prescription. Sertraline is of same class as fluvoxamine and is safe to use in elderly. You can discuss with his psychiatrist for that drug.

Apart from these drugs I would advise you to get his BP checked regularly. High BP further aggravate the problem. Try to play simple puzzles games with him which will increase in cognitive functions. Ask him to play brain games like Sudoku, Crossword games which will help in halting the progression.

Supplements rich in Omega-3-Fatty acids also help in delaying progression. Provide him proper family support and nutrition. There is no reason to fear but as dementia is a distressing illness continue to give medicines to him.

Thanks, hope this helps you. Do ask again if you have more doubts, I will be happy to help.

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