Dystextia: Just bad typing or a sign of stroke?
Tell-tale signs of a stroke or transient ischemic attack are slurred speech, facial droop, and unilateral weakness. Every first-year medical student knows that fact. But that’s so 20th century medicine. Recent case reports suggest an additional clue that is perhaps more applicable to today’s society: garbled texting.
As presented in February at the annual meeting of the American Academy of Neurology, a 40-year-old man in Detroit was noted to have been sending text messages to his wife she was unable to comprehend the night prior to admission. When this information was presented to the astute neurology resident on-call, it led to a work-up. The patient was asked to type “the doctor needs a new blackberry.” Instead, he typed “The Doctor nddds a new bb.” Seems like an innocent mistake. Except whereas most of us who make a typo acknowledge that we aren’t good at typing, have huge fingers or need to get a phone with larger keys, this patient couldn’t identify the spelling errors he had made.
Brain imaging revealed that the patient had suffered a minor ischemic stroke.
Further making the case intriguing, the patient had no difficulty reading, writing or comprehending language. Similar to the term “dysarthria” (which means “difficulty articulating”), the phenomenon of difficulty or abnormal texting is called “dystextia.”
This report comes months after a similar episode chronicled by the Archives of Neurology. In that report, a man noted his 25-year-old pregnant wife sending him several illogical text messages, prompting him to have her evaluated.
Further history revealed that she had previously been struggling to complete the intake paperwork at a check-up at her obstetrician’s clinic. MRI of the brain revealed an ischemic stroke.
Dystextia likely won’t be on the ABIM board exam this year. But with the growing dependence on text messaging as a primary means of communication, don’t be surprised if it appears on the exam by the time you re-certify.