How Jumbled Text Messages Could Help Diagnose a Stroke

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March 19 2013 12:46 PM

When Autocorrect Isn’t to Blame

A jumbled text message could help diagnose a stroke.

Text messaging.
Bad text messaging could save your life.

Photo by Thomas Northcut/Photodisc/Thinkstock

Given that stroke is the No. 1 cause of serious, long-term disability in the United States, and the third leading cause of death, most of us know a friend or family member who’s had one. This also means we’re at least anecdotally familiar with the warning signs—sudden numbness, blindness, trouble speaking, severe headache, or loss of coordination. But mounting evidence now suggests there’s a new symptom to be aware of, one that may even allow us to sound the alarm remotely: the garbled text message.

Of course, not every butt-dial, autocorrect, or drunken text message indicates a lack of blood to the brain. There are 75 billions texts sent each month, and most of them signify nothing more than our society’s eroding acquaintance with grammar. But research presented today before the American Academy of Neurology suggests some texts might foretell a more urgent problem.

Dr. Omran Kaskar and colleagues at the Henry Ford Medical Center in Detroit have written a case study to report the story of a 40-year-old man who sent strange texts to his wife while he was away on business. At first, the messages seemed to nothing more than disjointed thoughts or slips of the thumb: Oh baby your” and “I am happy.

Then, two minutes later: “I am out of it, just woke up, can’t make sense, I can’t even type, call if ur awake, love you.”

At the hospital, a battery of tests failed to discover any overt signs of stroke beyond mild facial drooping. (Even that more familiar symptom disappeared by the next day.) “He could read, he could write. He wrote a full sentence for us no problem. He spoke fluently,” Dr. Omran Kaskar, senior neurology resident at the Henry Ford Hospital in Detroit, told me. “The only issue he had was typing the text message.”

To learn more, doctors gave him a smartphone and instructed him to type, “The doctor needs a new Blackberry.” The patient typed instead, Tjhe Doctor nddds a new bb.”

When he was shown the text and asked to identify any mistakes, the man saw nothing wrong. These results helped diagnose an acute ischemic stroke. They also confirmed the most interesting case to date of dystextia—one in which muddled text messages were the sole manifestation of a patient’s stroke.

The behavior known as dystextia is only just starting to be understood (and identified) by stroke neurologists. Last winter, a young pregnant woman made headlines when her nonsense texts tipped her husband off that something was wrong. In that case, speech loss went undetected because the woman had lost her voice due to a coincidental cold. In Kaskar’s patient, speech was totally normal.

For all the negative effects associated with our increasingly smartphone-centric lives, these sorts of cases illustrate one of the as yet unexplored benefits of a phone on every hip. On Tuesday, Kaskar and his colleagues at the Henry Ford Medical Center in Detroit presented their case study to the American Academy of Neurology.

“I think we’re learning that we need to be more aware,” Kaskar told me. “If you know that you’re high risk for stroke due to age, high blood pressure, cholesterol issues, or you have things like atrial fibrillation that put you at increased risk, it may help for family members and friends to watch for something wrong with a text.”

Dystextia is so new, many professionals are still unaware of the term. Dr. Lawrence Wechsler, chairman of the Department of Neurology at the University of Pittsburgh, finds this research promising. He said, “I think this is a reflection of a specific problem with language, and it may be that in our modern world, texting is going to be a very sensitive measure of this particular language abnormality—one that tips us off to the fact that there is a disorder of language and symptom of stroke.” (Dr. Wechsler is unaffiliated with the Ford case study.)

As the largest generation in U.S. history ages, such warning signs could be increasingly useful for rapid diagnosis. The timestamps of relevant texts may even help doctors piece an event history together. This can be critical in the occurrence of stroke, where various circumstances lead to oxygen depletion of the brain and time is of the essence. Or as Dr. Kaskar put it, “Time is brain.”

And let’s remember, Gam-gam’s not the only one at risk. Nearly a quarter of all strokes happen to those who are 65 and under. A friend of mine had one when she was 19. She’s lucky to be alive—though college is a tough place to sport an eye patch. All the more reason everyone should know get familiar with the warning signs. And perhaps disable autocorrect.

Moral of the story? You may want to follow up on that unintelligible text-diatribe from your Aunt Claire. Of course, it’s most likely one of her standard conspiracy theories about Uncle Sam’s arsenal of bat drones. (Like that would ever happen.) But someday, it could be a different kind of cry for help.



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