Slurring Words (Dysarthria)

What slurring words means

Speaking takes precise, fast coordination of the breathing muscles, voice box, soft palate, tongue and lips. Dysarthria happens when the brain, nerves or muscles that control these structures are damaged. The result can be:

• slurred, mumbled or thick-sounding words
• speech that is too slow or too fast
• a quiet, hoarse, breathy or nasal voice
• uneven rhythm and volume
• difficulty moving the tongue or lips

Dysarthria is different from aphasia, a language problem where a person cannot find, understand or put words together. Both can happen in a stroke. With dysarthria alone, reading, writing and understanding are normal.

Sudden slurred speech

Stroke and TIA

Stroke is the most important cause to recognize. Slurred speech appears suddenly, often with weakness or drooping on one side of the face, an arm that drifts down, sudden loss of balance or vision problems. Use BE FAST: Balance, Eyes, Face, Arm, Speech, Time to call 911. A transient ischemic attack causes the same signs that clear within minutes to hours. It is a warning that a major stroke may follow and needs same-day assessment.

Other sudden causes

• Low blood sugar (hypoglycemia): in people taking insulin or some diabetes tablets, with shakiness, sweating and confusion.
• Alcohol and drugs: alcohol, sedatives, opioids, some anti-seizure drugs and lithium toxicity cause slurred speech and unsteadiness.
• Head injury: slurring after a blow to the head can mean bleeding in the brain.
• Bell's palsy: weakness of one whole side of the face makes some sounds hard to say, but there are no other stroke signs.
• Migraine: some migraines cause temporary slurring with aura. A first episode should still be treated as a possible stroke.
• Severe infection or sepsis in older adults, causing confusion and slurring.

Slurred speech that develops gradually

• Multiple sclerosis: "scanning" speech with uneven rhythm, often with numbness, vision problems and fatigue.
• Parkinson's disease: soft, monotone, rushed speech with tremor and slow movement.
• ALS (motor neuron disease): slurring with tongue twitching, swallowing problems and limb weakness.
• Myasthenia gravis: speech that becomes slurred or nasal the longer you talk, with drooping eyelids and double vision.
• Brain tumors, cerebral palsy, Huntington's disease and ataxias affecting the cerebellum.
• Mouth and tooth causes: loose dentures, a swollen tongue or mouth ulcers can make speech unclear.

Types of dysarthria

Does weakness cause speaking problems?

Yes. When the muscles of the face, tongue, palate and throat are weak, speech becomes slurred. That is why slurring often comes with drooling, choking on drinks and difficulty swallowing. Weakness that also affects the arms or legs points to the brain, spinal cord or a body-wide nerve or muscle condition.

How doctors find the cause

For sudden slurring, an emergency team checks blood sugar immediately and does a brain scan (CT or MRI) to look for stroke or bleeding. For gradual slurring, a neurologist examines the cranial nerves, strength, reflexes and coordination, and may order an MRI, blood tests, antibody tests for myasthenia gravis, and nerve and muscle studies (EMG). A speech-language pathologist assesses exactly which parts of speech are affected.

Treatment

• Treat the cause: clot-busting treatment for stroke within hours, correcting low blood sugar, adjusting medicines, or treating MS, Parkinson's or myasthenia gravis.
• Speech-language therapy: exercises to strengthen and coordinate the muscles, slow the rate of speech, and improve breath support and volume. Programs such as LSVT LOUD help in Parkinson's disease.
• Communication aids: alphabet boards, apps and voice-generating devices for severe dysarthria.

Tips for talking with someone who slurs

• Talk in a quiet room and face each other.
• Give them time, and do not finish their sentences.
• Ask them to repeat or rephrase rather than pretending to understand.
• Use yes or no questions if speech is very difficult.

Frequently asked questions

Why am I slurring my words all of a sudden?

Sudden slurring is a possible stroke and needs a call to 911 right away, even if it improves. Other sudden causes include low blood sugar, alcohol, sedatives and other drugs, and a head injury. Do not wait to see if it passes.

Can stress or tiredness cause slurred speech?

Extreme tiredness can make speech a little slower or less clear, and anxiety can make you stumble over words. True slurring that is new, or comes with other symptoms, should not be blamed on stress until a doctor has ruled out a stroke or neurological cause.

What is the difference between dysarthria and aphasia?

Dysarthria is a problem with the muscles of speech: words come out slurred but language is intact. Aphasia is a language problem: difficulty finding, understanding, reading or writing words. A stroke can cause either or both.

Can slurred speech be cured?

It depends on the cause. Slurring from low blood sugar, alcohol or medicines usually resolves fully. After a stroke, speech often improves over months with therapy. In progressive conditions like ALS or Parkinson's disease, therapy and devices help people keep communicating.