Case Report: "Dystextia" as a Sole Manifestation of Expressive Aphasia in Acute Ischemic Stroke (P03.175)

OBJECTIVE: Identify differing manisfestations of stroke-related symptoms through importance of a detailed language exam and the emergence of text messaging as signs of aphasia in the setting of acute infarct. BACKGROUND: Expressive Aphasia/Broca9s aphasia can be caused by a lesion in the left posterior inferior frontal gyrus. It is characterized by loss of ability to produce language, spoken or written. Bedside language examination consists of fluency, comprehension, naming, repetition, reading and writing. This case presented normal routine bedside language examination but abnormal message typing or "dystextia." DESIGN/METHODS: Case report of a patient presenting at Henry Ford Hospital. RESULTS: 40 year old, right handed, Caucasian male complained of slurred speech and right facial weakness. Patient9s NIHSS was 2. At midnight the night before, his wife received an unusual text message (SMS) from her husband. She stated that the SMS at the time were disjointed, non-fluent, and incomprehensible. [First SMS 12:22am: "Oh baby your;"] [Second SMS 12:22am: "I am happy;"] [Third SMS 12:24am: "I am out of it, just woke up, can9t make sense, I can9t even type, call if ur awake, love you."] Following day, patient had no observable neurologic deficits with exception of mild right facial asymmetry. No language deficits were noted on routine bedside examination. He was then asked to type the following sentence on a blackberry: “the doctor needs a new blackberry” and he typed “Tjhe Doctor nddds a new bb.” When asked if it was correct, he did not recognize any typing errors. CONCLUSIONS: Text messaging is a common practice of communication with >75 billion texts/month. Evaluation of "dystextia" may become a vital tool in determining language deficits in addition to the routine assessment. It also may help establish time of stroke symptom onset in patients who are in consideration for receiving acute stroke interventions as text messaging is always time/date stamped. Disclosure: Dr. Kaskar has nothing to disclose. Dr. Patel has nothing to disclose. Dr. Miller has nothing to disclose. Dr. Angus has nothing to disclose.