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‘Dystextia': Gibberish texts sound stroke alarm

By Ivan Oransky

NEW YORK (Reuters Health) - Imagine you were a devoted husband, waiting to hear from your wife about her due date after a visit to the obstetrician, and you saw these on your phone:

"every where thinging days nighing"

"Some is where!"

That's what happened last December to a Boston-area man, who knew that autocorrect - known for its bizarre replacements - was turned off on his 11-week-pregnant wife's phone.

You'd probably be tempted to make sure your wife, 25, got to the emergency room. When she did, doctors noted several signs of a stroke, including disorientation, inability to use her right arm and leg properly and some difficulty speaking.

A magnetic resonance imaging scan - MRI - revealed that part of the woman's brain wasn't getting enough blood, clinching the diagnosis. Fortunately, her symptoms went away quickly, and the rest of the pregnancy went just fine after she went home from the hospital on low-dose blood thinners.

The case, say three doctors from Boston's Harvard Medical School who reported it online today in the Archives of Neurology, suggests that "the growing digital record will likely become an increasingly important means of identifying neurologic disease, particularly in patient populations that rely more heavily on written rather than spoken communication."

The authors describe the phenomenon as "dystextia," which is the word used by other doctors in an earlier case involving a migraine, and symptoms of a stroke diagnosed for other reasons.

"In her case, the first evidence of language difficulties came from her unintelligible texts," one of the report's authors, Dr. Joshua Klein, told Reuters Health by email.

Strokes are rare in women aged 15 to 34, with about 11,000 per year, according to data from the U.S. Centers for Disease Control and Prevention published last year.

Dr. Sean Savitz, who directs the stroke program at the University of Texas Health Science Center in Houston, said he has seen a few patients who sent emails suggesting they were having difficulty with language, a condition known as aphasia.

Such clues usually come with other information however. In this case, for example, the patient's obstetrician's office later remembered that she had trouble filling out a form. And they might have caught the language difficulty earlier had the woman not had a weak voice, thanks to a recent upper respiratory infection.

"So, this case report per se does not indicate to me if dystextia is going to be more common to pick up strokes," Savitz told Reuters Health by email, "but I do think it will be a valuable addition to the collection of information that neurologists should obtain when taking a history."

"The main stroke warning signs with respect to texting would be unintelligible language output, or problems reading or comprehending texts," said Klein. "Many smartphones have an ‘autocorrect' function which can introduce erroneous word substitutions, giving the impression of a language disorder."

Autocorrect, said Savitz, a professor of neurology, can confuse matters - even for doctors.

"I have often joked with my colleagues when using the dictation of the smartphone, that it gives me an aphasia," he said. "Potential for lots of false positives!"

SOURCE: Archives of Neurology, online December 24, 2012.

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