Many folks are already aware of a Los Angeles reporter, Serene Branson, who was covering on live TV the Grammy's when she suffered symptoms of garbled speech (dysarthria being the medical term).
It was initially conjectured that she was in the middle of a stroke, TIA, seizure, or something else bad... but it finally was determined by her doctors that it was due to a migraine.
This scary incident brings me to explain what a speech and what a vocal problem is. First some definitions.
Voice is sound production. Speech is what ultimately comes out the mouth after the sound is modified by the throat muscles, palate, tongue, lips, teeth, etc. Examples of voice problems are hoarseness and breathiness. A speech problem would be stuttering, mumbling, or sounding nasal.
This distinction is very important as it helps point the right way to treatment. Otherwise time is wasted on the patient's part seeing inappropriate doctors. Generally, voice issues can be treated by an ENT as it generally is due to some physical voicebox problem whether it be vocal cord paralysis, vocal cord nodule, or spasmodic dysphonia.
Speech problems are due to the dis-coordination of the throat and mouth muscles and is NOT because of a physical problem that can be addressed surgically (generally speaking, though there are exceptions). The problem is at the brain level.
So taking the reporter above as an example... her vocal quality was quite normal. What was abnormal was her speech. Given the speech difficulties, the problem was at the brain level and not the voicebox. As such, an ENT is NOT the right doctor to see, but rather a neurologist.
However, there is one speech issue that CAN be addressed by an ENT quite well and that is nasal-sounding speech due to irregular nasal airflow (either too much or too little).
In this video, the patient suffered from a severe phlegmy throat after suffering from a stroke. His secretions did not pass down to his stomach, but rather collected in his throat causing constant throat-clearing and coughing up clear phlegm.
As you can see in the video, there is a tremendous amount of mucus pooling present.
Treatment was geared toward improving his swallowing function so that his secretions would not collect in his throat.
If you are not sure what normal is supposed to look like, click here.
CNN on April 8, 2010 aired a story on obstructive sleep apnea (OSA) and the risk it poses to men who do not address it. Apparently, according to a new study out of the March 2010 issue of the American Journal of Respiratory and Critical Care Medicine ("Obstructive Sleep Apnea Hypopnea and Incident Stroke: The Sleep Heart Health Study"), the risk of stroke increases by as much as 3X if left untreated in men with OSA. The risk of stroke increases even in men with MILD sleep apnea. The risk appears higher in men than women mainly because men seem to get it earlier and live with it longer than women.