[56F] With uncontrollable movements and slurred speech

Patient Description

A 56-year-old female has been experiencing uncontrollable jerky movements in her arms, legs, hands, and face for the past three weeks. These movements are sudden, sharp, and constant. Along with these movements, she has also been experiencing slurred speech. Additionally, she has muscle pain that feels like 'bone rubbing on bone,' which she rates as an 8 out of 10 in severity. She has not had any recent injuries or accidents that could explain the muscle pain. She has also been experiencing tremors throughout her body and has had difficulty with balance and walking. However, she has not experienced any changes in vision, difficulty swallowing, changes in sense of smell or taste, or recent head trauma. There have been no new medications, exposures to new environments, chemicals, or substances, and no recent travel. There is no family history of similar symptoms or neurological disorders, and she does not have any pre-existing conditions or chronic illnesses. She is not currently taking any medications, over-the-counter medications, supplements, or topical medications, and has not recently stopped taking any medications.

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Arora's Assessment

What might be happening

Based on the symptoms you've described, here are some possible explanations:

  1. Parkinson's Disease: This is a progressive neurological disorder that can cause tremors, muscle stiffness, and difficulty with balance and coordination. The sudden onset of symptoms is less typical, but it can present with jerky movements and slurred speech.

  2. Huntington's Disease: This is a genetic disorder that causes the progressive breakdown of nerve cells in the brain. It can lead to uncontrolled movements, emotional disturbances, and cognitive decline. However, it usually has a gradual onset and a family history of the disease.

  3. Stroke or Transient Ischemic Attack (TIA): A stroke or TIA can cause sudden onset of neurological symptoms, including jerky movements, slurred speech, and confusion. Immediate medical attention is crucial to rule this out.

  4. Medication or Substance-Induced Movement Disorders: Although you mentioned no new medications, some medications or substances can cause movement disorders as side effects. It's important to review all medications and supplements with a healthcare provider.

  5. Infections or Inflammatory Conditions: Certain infections or inflammatory conditions affecting the brain or nervous system can cause sudden onset of neurological symptoms. Examples include encephalitis or autoimmune disorders.

What you can do

Uncontrollable Movements and Slurred Speech:

  • Seek Immediate Medical Attention: Given the sudden onset and severity of symptoms, it's crucial to see a healthcare provider as soon as possible. They may recommend imaging studies like an MRI or CT scan, blood tests, and possibly a referral to a neurologist.
  • Document Symptoms: Keep a detailed journal of the symptoms, including their frequency, duration, and any potential triggers. This can be helpful for your healthcare provider.
  • Safety Measures: Ensure a safe environment to prevent falls or injuries due to balance issues. Remove tripping hazards and consider using assistive devices if needed.

Muscle and Bone Pain:

  • Pain Management: Over-the-counter pain relievers like acetaminophen or ibuprofen may help alleviate some of the pain. However, consult with a healthcare provider before starting any new medication.
  • Gentle Exercise: Engage in gentle stretching and low-impact exercises to maintain muscle strength and flexibility. Physical therapy may also be beneficial.
  • Heat and Cold Therapy: Applying heat or cold packs to the affected areas can help reduce pain and inflammation.

What you should look out for

Given the severity and sudden onset of your mother's symptoms, it's important to seek medical care as soon as possible. Reasons to seek care even more urgently include:

  • Worsening Symptoms: If the jerky movements, slurred speech, or muscle pain worsen.
  • New Symptoms: If new symptoms such as severe headache, vision changes, or difficulty breathing develop.
  • Falls or Injuries: If she experiences any falls or injuries due to balance issues.

Remember, while I can provide information and suggestions, it's essential to consult with a healthcare provider for a formal diagnosis and appropriate treatment. You can also use MDandMe to journal symptoms, track progress, get insights, and share longitudinal medical notes with your provider.

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4 mo ago

People Also Ask


What are the common symptoms of Parkinson's Disease?

Common symptoms of Parkinson's Disease include tremors, muscle stiffness, slowness of movement, and difficulty with balance and coordination. Other symptoms can include changes in speech and writing, and in some cases, cognitive changes.


How is Huntington's Disease diagnosed if there is no family history?

Huntington's Disease is typically diagnosed through genetic testing, which can confirm the presence of the gene mutation responsible for the disease. A neurologist may also conduct a thorough clinical evaluation, including a review of symptoms and family history, even if there is no known family history.


What are the signs of a stroke or TIA that require immediate medical attention?

Signs of a stroke or TIA that require immediate medical attention include sudden numbness or weakness in the face, arm, or leg, especially on one side of the body; sudden confusion, trouble speaking, or understanding speech; sudden trouble seeing in one or both eyes; sudden trouble walking, dizziness, loss of balance or coordination; and sudden severe headache with no known cause.


Can infections or inflammatory conditions cause sudden neurological symptoms?

Yes, certain infections or inflammatory conditions, such as encephalitis or autoimmune disorders, can cause sudden neurological symptoms. These conditions can lead to inflammation of the brain or nervous system, resulting in symptoms like jerky movements, slurred speech, and balance issues.


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