Garbled speech

In a double-blind, placebo-controUed study of the use of intravenous lidocaine for neuropathic pain, 16 patients were given 5 ml/kg intravenously over 30 minutes (10). Lidocaine was better than placebo in relieving pain. The major adverse effect was light-headedness, which occurred in seven patients given lidocaine and none given saline. Other adverse effects included somnolence, nausea and vomiting, dysarthria or garbled speech. 

A 47-year-old man developed 30-second episodes of facial contortions, aphasia, garbled speech, neologism, nocturnal episodes of deep breathing, swallowing, and incomprehensible speech after taking trazodone 150 mg/day for 3 weeks. On withdrawal of trazodone, his symptoms abated, but an electroencephalogram showed a left anterior lobe spike. He was treated with carbamazepine and within 6 months was not depressed and had no further convulsive symptoms. 

A 47-year-old woman, with a history of amphetamine abuse, depression, and paranoia, smoked heroin for 4 weeks after stopping amphetamines, and 10 days later became drowsy and confused with increased paranoia and depression. She was disoriented and restless. Her speech was garbled. She had frequent non-purposeful movements and an unsteady gait. A CT brain scan was normal. She was given chlorpro-mazine, doxepin, and diazepam, but her ataxia and incontinence worsened, her speech and all her... 

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