Question:
My nephew is currently in the hospital suffering froman infection in the left brain. There are lesions and tumorsapparent in the cat scans. He probably will never talk again. Theygive him 7 months to live.

When I get a simple blood test done, the results arenever back in two days.

Are spinal taps that much faster? Are spinal tapsregularly administered to people who have sudden trouble talking?

MRI? Is MRI equipmentgenerally scheduled ahead? Does AIDS really cause brain tumors?

Answer: For most people, the left brain is the dominant (virtually only, givenour present understanding) speech center. An infection is more than likely tocause problems. Motor speech control is generally localized in the frontallobe on the left, in Broca's area. But, hearing and speech are complexprocesses which involve much more than just that.

Predictions of death are sophomoric, and often are reported as such byfamilies who do not understand what is said to them, and interpret them viaHollywood. The physicians consulted may have given outcomes in terms ofstatistical demographics, and thus made general statements about probablecourse and term of events, but would be very unlikely to have stated exactoutcomes. People do vary.

Spinal taps are frequently part of a complete neurological examination. Theywere routinely done for some cases at the Neurological Institute. They can becontraindicated in some circumstances. However, when there is a bleed orinfection possibly present in the CNS (central nervous system), the spinalfluid may be a useful tool: blood, elevated white blood cell count, elevatedprotein level from breadkdown products, and so on.

Having trouble talking (motor aphasia) is merely a symptom, whose cause has tobe determined. Whether a spinal tap is included in the workup depends on whatthe suspected cause may be, looking at the other indicators.