EmergencyEmergency Guide

Slurred speech: Red Flags & Emergency Signs

Slurred or garbled speech is a stroke warning sign — use the FAST test and call 999 immediately if it is sudden onset.

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If you have this symptom right now

Call 999 (UK) / 112 (EU) / 911 (US) immediately if any emergency warning signs are present. Do not drive yourself. Do not wait to see if it improves.

🚨 Call 999 / 112 Immediately

⚠Sudden slurred speech with facial droop or arm weakness — stroke (FAST positive), call 999 immediately
⚠Sudden inability to find words or understand speech (dysphasia/aphasia) — stroke
⚠Slurred speech with altered consciousness — metabolic emergency (hypoglycaemia, drug toxicity, sepsis)
⚠Slurred speech following head trauma — intracranial haemorrhage

•Slurred speech that resolves within hours — TIA (high risk of completed stroke within 48 hours)
•Slurred speech with double vision and unsteady gait (posterior circulation TIA/stroke)
•Slurred speech with tongue weakness and dysphagia (bulbar palsy — MND, GBS, brainstem stroke)

When slurred speech occurs together with any of these symptoms, urgency increases significantly:

Classic stroke triad — FAST positive, 999 now

Encephalopathy or brainstem stroke

Posterior circulation stroke — vertebrobasilar territory

Haemorrhagic stroke presenting with speech change

CT/MRI brain; thrombolysis <4.5 hours for ischaemic

Transient Ischaemic Attack (TIA)urgent

ABCD2 score; dual antiplatelet; carotid imaging

Mimics stroke; BG <3.5 corrects speech deficit

MRI + LP; empirical IV aciclovir

Differential diagnosis analyses:

→Any sudden slurred speech — do not wait to see if it improves
→FAST positive: Face drooping + Arm weakness + Speech slurred = Time to call 999
→Slurred speech following any head injury