dr-exmedic.com

Just for the record, so there’s absolutely no doubt about this:  expressive aphasia (even if mild) is a deficit.  Since speech is controlled by the neurological system, expressive aphasia is a neurological deficit.  Since there is a single place (or “focus”) in the brain responsible for speech, expressive aphasia is a focal neurological deficit. And if this happens suddenly, you have what is called a “sudden-onset focal neurological deficit,” which, the last time I checked, was one of the leading symptoms of CVA, also known as a stroke.

Which means that if you have a patient in your ambulance with sudden onset expressive aphasia, you really, really need to call it in as a stroke alert.  Not that there’s anything that’s happened recently that made me think of this….

(I will grant you that technically such a patient would be negative on the Cincinatti Prehospital Stroke Scale.  Allow me then a shameless plug for the talk I’m giving at the region’s annual EMS conference, which is properly titled “Beyond the CPSS” but is essentially how to do a cranial nerve exam in about a minute–and the brochure lists my lecture’s subtitle.  If you happen to be in Western PA later this month, stop by and pretend to learn!)