Oral/Motor and Voice: Larynx Injury?

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Larynx Injury?

Posted by LeslieR on 8/3/2006, 7:33 am
68.42.150.20

I am not a school speech pathologist, but I work for a school district, does that count? :) I was wondering if anyone has encountered anything similar to my experience (sorry for the long post)
I recently suffered a fall where I fell directly onto my chin (I fell slightly to the right and my right hand was in my pocket - don't know what my left hand was doing). I tripped on a loose carpet at school - a cement floor with a layer of vinyl tile and a commercial runner. I had a myriad of tests done. CAT scan of the brain and neck, MRI of the head and neck, MRA (for the carotid artery), C-Spine and Chest x-rays all were negative. My barium swallowing test showed that a pill got stuck in the bottom of the esophagus, but yet the sensation was referred to my upper throat.
Enough of background. Immediately after the fall, I had trouble with scattered words. For instance, I had difficulty saying sensitivity (to light). However, the clinic doctor didn't think my sensitivity to light, nausea, headache, and stuttering warranted even shining a light in my pupils! But that's another story.
Day 2: Increasing difficulty with speech, mainly stuttering, and a sort of "swallowing" of words. Went to ER and had CAT scan. They sent me home with post-concussive syndrome, and instructions to return if symptoms worsen.
Day 3: Speech is now entirely a series of stutters and/or involuntary gutteral sounds. Went back to clinic (work required). Sent me home with instructions to see a neurologist.
Day 4: Speech spontaneously resolves. One hour later, it is back to stuttering and began having problems chewing and swallowing (now I realize at least part of it was my tongue). I could then swallow or simply turn my head and the speech would return to normal for anywhere from a few seconds to a minute. Went back to ER and they admitted me.
Day 5: Exhausted all day - feel like I was pumped full of narcotics even though on just ibuprofen. Still doing neck trick for docs - they are baffled. Cannot do lalalalalala or the rapid forefinger to thumb movement on the right side, but that resolves when my speech does.
Day 6: Speech changes from stuttering to a painful (to listen to) drawl. Notice a bit of motor insufficiency in my right hand as well. In the evening, talk a walk down the hospital corridor - my gait feels a little sluggish, but resolves for about 30 seconds when my speech returns. All of a sudden, my legs collapse under me and my speech again returns to its drawl. Attending doc says its just fatigue. All day, noticed a "warming" sensation in my chest on and off.
Day 7: "Warming" sensation now precipitates a return to normal speech for various periods. Can no longer do the "neck trick." Speech is a little better. Discharged from hospital.
Day 8: Speech continues to improve. Can now tell when speech will return to normal for a time (now it can be minutes) because of sensation. Relapse into abnormal speech, if in the middle of a word, results in a spasm or something that causes the chin to jut up/forward and the word to become garbled. After videotaping myself, I can see that my eyes roll back and flutter a few times while the chin is jutted, sometimes my chin will collapse onto my chest before being able to continue speaking. Am actually feeling quite good, and speech is about 50/50. Until I take a nap. Upon waking, speech is regressed a couple of days, and my right side motor skills are not good. This resolves in about 1.5 hours to previous level.
Day 9: Speech is more normal than not. Still quite fatigued. Noticed that right motor skills (finger to thumb) and lalalalala now is not always good even when my speech is "normal." Think this is all part of healing process. Go to see dentist who posits that the recurrent laryngeal nerve may be getting pinched by some swelling/bruising of the larynx or throat. Since when I fell, my chin was pushed toward my throat, that makes sense to me, and is the first time anyone has hazarded ANY guess.
So, it is Day 10. Speech seems normal, but it is early in the day. Still fatigued, but imagine that is to be expected with a concussion. I have an appointment in 6 days with a PMR doc - will probably schedule speech therapy if this is not entirely resolved.
So, does this familiar to anyone? Any other theories? Oh, and when I was having the major stuttering, I was able to read something printed aloud with just about perfect diction.
Thanks for any and all replies. Please forgive if my post is not relevant.
Leslie