Trump's slurred speech: Drunk, Dentures or Stroke?

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While President Donald Trump was giving his historic speech Wednesday to announce that the United States would recognize Jerusalem as the capital of Israel, some on the internet focused on the manner in which he made his statement.

Toward the end of the news conference, some on Twitter and Facebook noted that the President's usual speech pattern changed and that he started to slur his words -- and they speculated about what it could mean.

The official term for slurred speech is dysarthria, when the muscles you use to speak weaken or you have a hard time completely controlling their use.

People can slur their words for any number of reasons. It can be a sign of problems with a nervous system disorder like a brain tumor or a stroke. People who have cerebral palsy or Guillain-Barré Syndrome can struggle with slurring. Multiple sclerosis, muscular dystrophy, Lyme disease, Huntington's, Myasthenia gravis, amyotrophic lateral sclerosis, Parkinson's and Wilson's disease all can cause it.

Dental work -- such as ill-fitting dentures -- can also be blamed. Medication can impact speech, as can drugs and alcohol. Or people can simply slur their words when they get tired.

CNN's Chief Medical Correspondent, Dr. Sanjay Gupta, a practicing neurosurgeon, said he watched the video closely a few times. "There is clearly some abnormalities of his speech," he said. "You could call it slurring or just a little bit of difficulty forming the words."
Michael de Riesthal, a speech and language pathologist, agrees. "There was definitely some imprecise progressive change in articulatory precision and slowing of his speech that is not typical in normal speech," said de Riesthal, an assistant professor in hearing and speech sciences at Vanderbilt University Medical Center and the director of the Pi Beta Phi Rehabilitation Institute. "The distortion of his articulation, though, is unknown in etiology."
Neither Gupta nor de Riesthal has ever treated Trump for any reason.

De Riesthal said the distortion was particularly noticeable when the President said "United States."

Although Trump has what de Riesthal would characterize as a typical Queens, New York, accent, "this was a noticeable change for his speech." It could be anything, though, especially since it seemed like he was "working hard to speak" -- as if "having a denture fall or some other alternative explanation." However, it definitely "seemed too unusual for something like that to be dry mouth."

Gupta noted that for most of the 10- to 11-minute speech, the President spoke fine. One sign that it was unlikely to be a bigger medical concern: After the speech,Trump walked over to a desk, pulled out the chair, sat down and signed a proclamation. All normal movements.

"All of that is relevant because he doesn't appear to have any motor weakness," Gupta said.

With a stroke, for instance, you would often see more indications of weakness or drooping of the face. "It would be very unusual to have problems that are isolated to struggling with a few words," Gupta said.

Of course, it is difficult to diagnose someone from only a video, but the problems may stem from mouth issues, Gupta said.

"I noticed that he clears his mouth after finishing speaking, so whether that was a dry mouth or a misplaced dental issue is unclear, but given everything else, that is a much more likely cause of that," he said.

Asked whether Trump was feeling OK at the end of the speech, a White House official said, "The President is perfectly healthy; he's been working in meetings all day and in fact is still here working now."

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