March 08, 2011

Reporter Suffers Garbled Speech on Live TV

Many folks are already aware of a Los Angeles reporter, Serene Branson, who was covering on live TV the Grammy's when she suffered symptoms of garbled speech (dysarthria being the medical term).

It was initially conjectured that she was in the middle of a stroke, TIA, seizure, or something else bad... but it finally was determined by her doctors that it was due to a migraine.

This scary incident brings me to explain what a speech and what a vocal problem is. First some definitions.

Voice is sound production. Speech is what ultimately comes out the mouth after the sound is modified by the throat muscles, palate, tongue, lips, teeth, etc. Examples of voice problems are hoarseness and breathiness. A speech problem would be stuttering, mumbling, or sounding nasal.

This distinction is very important as it helps point the right way to treatment. Otherwise time is wasted on the patient's part seeing inappropriate doctors.

Generally, voice issues can be treated by an ENT as it generally is due to some physical voicebox problem whether it be vocal cord paralysis, vocal cord nodule, or spasmodic dysphonia.

Speech problems are due to the dis-coordination of the throat and mouth muscles and is NOT because of a physical problem that can be addressed surgically (generally speaking, though there are exceptions). The problem is at the brain level.

So taking the reporter above as an example... her vocal quality was quite normal. What was abnormal was her speech. Given the speech difficulties, the problem was at the brain level and not the voicebox. As such, an ENT is NOT the right doctor to see, but rather a neurologist.

However, there is one speech issue that CAN be addressed by an ENT quite well and that is nasal-sounding speech due to irregular nasal airflow (either too much or too little).
Fauquier blog
Fauquier ENT

Dr. Christopher Chang is a private practice otolaryngology, head & neck surgeon specializing in the treatment of problems related to the ear, nose, and throat. Located in Warrenton, VA about 45 minutes west of Washington DC, he also provides inhalant allergy testing/treatment, hearing tests, and dispenses hearing aids.

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