If you use your phone to send and receive text messages, you've seen your share of gibberish, often due to the auto correct feature. It can turn "Meet you at the theater around noon" into "Newt you anyone heater around Jon." Doctors in Boston have found what they believe to be the first instance where an odd text message was used to help diagnose a stroke. A man received a garbled message from his wife. But this wasn't just a line or two. This was a whole conversation that didn't make sense. He was alarmed enough to get her to an emergency room where she was diagnosed with a stroke. ABC News wrote about the incident, which was reported online in this week’s Archives of Neurology.

By Robert Shmerling, M.D.
Harvard Medical School

What Is the Doctor's Reaction?

It’s a remarkable story. A pregnant woman texts her husband but the message comes out as gibberish. Fearing something is wrong, he gets her to an emergency room where she is diagnosed with a stroke.

As reported by Boston neurologists in Archives of Neurology, this story may be the first instance of a stroke detected because of an inability to text properly. It may sound like a new way to detect stroke. Yet, this is not so different from a much older detection system: conversation. A sudden difficulty communicating clearly – whether in person, talking on the phone or texting – should raise concern about a stroke. And that is the message of this story: The husband recognized a problem and quickly got his wife medical attention.

Something similar happened with my father. My mother was having trouble understanding him. She called me and put him on the phone. He was not making sense. I asked him to put her back on the line and I told her to take him to the emergency room. We later learned he had the flu and a high fever. The fever made him confused, a common event among the elderly. But it could have been a stroke needing emergency treatment.

The interesting twist in the case of the pregnant woman was that the problem was detected by abnormal texting. Of course, detecting trouble due to a nonsensical text is only reliable if the phone’s “auto-correct” feature is turned off, as it was in the case of the pregnant woman. If you’ve ever received or sent a misspelled text, you know that auto-correction is a common cause of nonsensical texts.

Identifying abnormal brain function through texting is not so different from the way neurologists evaluate patients by asking them to write a sentence, copy shapes or draw a clock. These tasks challenge various parts of the brain to see whether they are working correctly. Perhaps asking a patient to type a text or asking about the clarity of their texts will become a common way to assess brain function.

What Changes Can I Make Now?

If you notice signs of stroke in yourself or someone you’re with, get help immediately. Some emergency treatments, including the use of drugs to dissolve blood clots in the arteries of the brain, work best within a few hours after symptoms start.

The symptoms of stroke include the sudden onset of:

• A drooping lip or other abnormal appearance of the face
• Weakness on one side of the body
• Loss of vision
• Garbled speech or other trouble communicating
• Difficulty walking or loss of balance
• Confusion

You can reduce your risk of stroke. Risk factors you can modify include:

• High blood pressure (hypertension)
  Get your blood pressure checked regularly. If it’s high, talk to your doctor about how diet, exercise and medications can bring it down.
• An unfavorable lipid profile (high total or LDL cholesterol or low HDL cholesterol)
  Review treatment options with your doctor. Treatment might include dietary changes, losing excess weight, medications or a combination of these.
• Diabetes
  Get your blood sugar checked periodically. If you have diabetes, discuss with your doctor how to lower your blood sugar. Additional medications, such as aspirin and ACE-inhibitors, may be recommended to prevent complications.
• Smoking
  If you smoke, make a commitment to quit. Ask your doctor about programs that can help.
• An irregular heartbeat
  Let your doctor know if you feel faint or have palpitations. You might have atrial fibrillation. This is a risk factor for stroke because blood clots may form in the heart and travel to the brain. Treatment to restore a normal heart rhythm and blood thinners can reduce this risk.

A family history of cardiovascular disease or stroke at an early age is also a risk factor for stroke. This makes reducing other risk factors (as listed above) is even more important.

If you have had a stroke before or have stroke risk factors, talk to your doctor about which hospitals near you provide the best stroke care.

What Can I Expect Looking to the Future?

It’s hard to predict how communication will change. And it’s even harder to predict how changes can be applied to healthcare. The report of stroke detected by texting shouldn’t be surprising. A stroke can disrupt any form of communication. The only question is whether we’ll recognize it when it happens.