Sudden slurred speech in elderly. Contact your doctor any time you are worried about your .


Sudden slurred speech in elderly Apraxia of speech may result in difficulty initiating speech or mispronunciations. The disorder may have a single cause or more than one cause. [1] Decreased speech intelligibility characterizes the disorder. Dysarthria means slurred speech. The disease causes a breakdown in your brain’s nerve cells, which causes body movement control problems, as well as thinking, decision-making and memory trouble, and personality changes. Your speech may only be slightly unclear, or you may not be able to speak clearly at all. Subdural hematomas can be life-threatening, so it’s crucial to see a healthcare provider whenever you have a head injury. It has lasts approximately 4 hours or so. This can be helpful to the neurologist, who will look for the underlying cause. It’s also possible that infections, medication interactions, dehydration , or the exacerbation of existing neurological conditions are responsible. One warning sign that you're lacking the vitamin can be seen in your speech. Aug 8, 2018 · Strokes are one of the leading causes of slurred speech in the elderly. Medicare pays for that. What causes these changes is usually not known. Jul 12, 2024 · To diagnose dysarthria, a speech-language pathologist might evaluate your speech to help find out the type of dysarthria you have. Caregivers can also teach the seniors different ways of communicating without verbal cues. Problems enunciating words may be linked to a more severe, underlying disorder, so be sure to seek medical advice. What are the early signs and symptoms of dysarthria? The primary symptom of dysarthria is unclear or garbled speech. Speech therapy builds or rebuilds your understanding of language and teaches you skills to adapt to specific symptoms. Other conditions may also produce these symptoms. Aug 9, 2024 · It is essential for anyone struggling with slurred speech to continue to work on improving their communication skills. The family members of a 72-year-old female state that the patient complained of a sudden, severe headache; had slurred speech; then became unresponsive. Sep 27, 2023 · Dysarthria, a motor speech disorder, causes slurred or unclear speech. Mononucleosis is an infection that causes fatigue and severe sore throat that could cause speech problems. Other causes of symmetric cranial nerve weakness include botulism or use of botulinum toxin for cosmetic concerns and the Miller Fisher variant of Guillain-Barré syndrome. Note the time when any symptoms first appear. The cause of a transient ischemic attack is similar to the cause of an ischemic stroke, which is the most common type of stroke. It often affects older adults or people experiencing alcohol withdrawal. Symptoms like a headache and slurred speech can develop right after the injury or days to months later. Is the speech slurred or strange? T—Time: If you see any of these signs, call 9-1-1 right away. This information helps health care providers determine the best treatment. Other symptoms include: difficulty moving your mouth, tongue or lips; slurred or slow speech Jan 10, 2023 · Sudden changes in an elderly person’s voice, such as increased hoarseness, changes in voice patterns, or slurred speech are key indications of speech problems. A number of causes can be responsible for triggering this condition in the elderly. The cerebellum helps control balance, eye movements, swallowing and speech. Just like other body parts that change with age - like eyesight and hearing - speech and the ability to communicate can also be affected by aging. Elderly individuals with dysarthria sometimes find it too difficult to communicate and, as a result, will become withdrawn and isolated. Jul 15, 2020 · VITAMIN B12 is an essential ingredient for the body so lacking it can produce an array of unusual symptoms. The sudden onset of slurred speech is a warning sign for stroke; if this happens, seek immediate medical assistance. This may cause an abrupt mental change, sometimes accompanied by paralysis or slurred speech. Hyperactive delirium causes fast, erratic symptoms, such as restlessness, rapid nonsense talk and strong urges towards reckless behaviour. Delirium occurs when signals in the brain aren't sent and received properly. Overuse of medications can cause toxicity and under-use can cause pain and discomfort, all which can further worsen delirium. However, the symptoms progressed, and she eventually also noticed difficulty thinking of the “right words to say. Read more about the different types of aphasia. These signs may be accompanied by more subtle symptoms, like trouble consuming food or struggling with certain pronunciations. In an ischemic stroke, a blood clot blocks the blood supply to part of the brain. Dysarthria, which is a problem with pronunciation and the rhythm of speech. Ways to Manage Sundowner’s Syndrome Sep 30, 2024 · It’s like a sudden earthquake in our neural landscape, potentially shifting and damaging the delicate structures involved in speech production. Sometimes no cause can be found. Degenerative diseases such as Parkinson’s disease, Huntington’s disease and certain Ataxias can all lead to slurred speech as they progress. Symptoms include: Weakness or drooping on one side of their face. Oct 24, 2024 · S—Speech: Ask the person to repeat a simple phrase. Another sign to look out for is hearing loss. Nov 8, 2012 · Based on symptoms of bilateral cranial nerve weakness in an elderly man without other symptoms, myasthenia gravis is at the top of the list of possible causes. This typically arises due to issues with the muscles involved in speaking, resulting in slow, slurred, or even jumbled speech. Speech-language pathologists (SLPs) work with individuals to develop their speech and difficulties in the languages and develop personalized Apr 23, 2024 · Other Causes of Sudden Speech Problems. Feb 12, 2024 · This causes speech to be strained or harsh. Examples include drooping of the face, one-sided weakness or numbness, and garbled speech. Causes of sudden confusion. Elderly people are more likely to have medical conditions that can lead to problems with speech or the voice. It also has other possible causes that are not related to nervous system problems. Older adults may experience dizziness for many reasons. As each person is affected differently by balance and dizziness problems, speak with your health care professional for individual advice. If a person shows signs of a stroke, take them to the ER immediately. Amyotrophic Lateral Sclerosis (ALS): ALS is a progressive neurological disease that causes muscle weakness, including those involved in speech. A seizure is when there is a sudden burst of electrical activity in the brain. What is Slurred Speech (Difficulty Speaking)? Slurred speech or difficulty speaking which is medically referred to as dysarthria, occurs when a person's words become unclear or hard to comprehend. Some of the tips listed below can help ease the challenges related to slurred speech but Sep 18, 2023 · Rapid or slowed speech, stuttering, and slurring are all possible symptoms. But a sudden voice change in elderly folks is another matter entirely because hoarseness brought on suddenly has a much greater range of potential causes. Oct 7, 2024 · If you have long-term or permanent brain damage, speech therapy can improve your language abilities. But it can also come on gradually from a slow-growing brain tumor or a disease that causes progressive, permanent damage (degenerative). A person Their speech is poorly pronounced (such as slurring), and the rhythm or speed of their speech changes. During the speech evaluation, the speech-language pathologist listens carefully to your speech and identifies features of dysarthria. This can make it difficult for you to make yourself understood. This can manifest as slurred speech, difficulty swallowing, and impaired breathing. The content of the spoken language remains intact, so the patient can write and comprehend spoken and written language. In fact, speech problems in the elderly are more common than you may think. Brain damage. A swelling in the throat, or muscle and nerve problems, can also lead to slurred speech. , Parkinson's disease, multiple sclerosis), vocal cord disorders, and psychological factors. Speech Therapy (Speech-Language Pathology): Speech therapy is a cornerstone of treatment for speech problems in the elderly. Some medications that affect the brain or nervous system, or muscles of speech, may result in dysarthria as a side effect. Sep 30, 2024 · – Sudden, severe headache (often described as the “worst headache of my life”) – Confusion or disorientation – Slurred speech – Weakness on one side of the body – Vision problems – Loss of balance or coordination – Nausea and vomiting – Seizures – Loss of consciousness Sep 30, 2024 · – Sudden, severe headache (often described as the “worst headache of my life”) – Confusion or disorientation – Slurred speech – Weakness on one side of the body – Vision problems – Loss of balance or coordination – Nausea and vomiting – Seizures – Loss of consciousness Jun 20, 2023 · Delirium is a sudden change in a person’s mental function. Brain damage due to a stroke is the leading cause of dysarthria. The voice might sound breathy, nasal, slurred, fast, slow, out of rhythm, very loud, or very quiet. You observe that the client has slurred speech and appears confused. If slurred speech is at a severe level, individuals may require the help of a communicative device. Unraveling the Mystery: Diagnosis and Treatment of Neurologically-Induced Slurred Speech. May 8, 2024 · When we think of strokes, we often think of symptoms like slurred speech, numbness, or loss of movement in the face or body. Get medical help if someone suddenly becomes confused or delirious. We’ll also discuss key symptoms, prevention strategies, and effective treatment options to help seniors recover and maintain cognitive Nov 6, 2019 · slurred speech; slow speech; rapid speech; abnormal, varied rhythm of speech; Tourette syndrome is a neurological disorder that causes repeated, involuntary physical tics and vocal outbursts Jul 19, 2022 · When you imagine what an elderly person’s voice sounds like, you probably think of something quiet and wispy, maybe even a little hoarse. Oct 24, 2022 · Confusion and slurred speech can be seen with many conditions including alcohol intoxication, drug use, medication reactions or side effects, dementia conditions such as Alzheimer's disease, or head trauma. She has woken up for the last 4 days with very slurred speech and some babbling. Dysphonia, which is a speech disorder that gives a hoarse quality to the voice. Articulation cues; Hierarchy of speech sounds; Pacing board; Communication partner training; Intelligibility tips; See the Motor Speech Pack for premade patient handouts and worksheets. Dysarthria often causes slurred or slow speech that can be difficult to understand. It can make it difficult to move your facial and mouth muscles, resulting in slurred speech. Sudden slurred speech in the elderly may be due to a stroke or transient ischemic attack (TIA). For example, a medical condition combined with the side effects of a medicine could cause delirium. Is Slurred Speech a Serious Health Condition? To understand this health condition, we must first look at what causes slurred speech. Jan 3, 2025 · What causes dizzy spells in elderly people? Common Causes of Dizziness in Older Adults. While no definitive test can detect sundowner’s syndrome, doctors will ask about the patient’s symptoms so other possible causes can be ruled out. Alcohol is widely known to cause slurred speech because it slows down how the brain communicates with the body. g. Causes of aphasia. Slurred speech after a stroke is the most common symptom of diagnosis and long lasting after Apr 11, 2023 · Some causes of dysarthria, like stroke, require emergency medical care. Heart failure-Tiredness-Shortness of Jan 30, 2024 · Causes. He also reported that he had gradually and unintentionally lost 20 pounds and had loss of appetite, constipation, and chronic itching. Heart attack. Some genetic changes have been linked to frontotemporal dementia. Discusses potential causes of speech problems, such as neurological conditions (e. A pathology that causes difficulty moving the muscles in your mouth and face that control speech often cause dysarthria. Here are common causes of speech loss: 1. In this MedBlog, we discuss risk factors, symptoms, and two new programs that can help prevent and manage delirium. Symptoms depend on the area and extent of brain damage. Explores the various factors and conditions that can contribute to speech problems in adults. By the age of 90 years, more than 10 % of the population would have experienced a stroke and 30 % wo … May 11, 2021 · Examples are room-spinning dizziness (vertigo), thick or slurred speech (dysarthria), or abnormal or clumsy gait (ataxia). Smith, a UTI is the most common cause of a sudden increase in confusion in dementia patients. Oct 3, 2019 · Adult speech impairments involve difficulty with verbal communication, including slurred, stuttered, rapid, and slowed speech. Apr 14, 2014 · Causes. It can be caused by an injury to the nerve that affects the larynx or a tumor in the brain stem. Aug 31, 2020 · These symptoms can be associated with different medical conditions including multiple sclerosis and anemia, although slurred speech is less common with anemia. Difficulties with articulation can look like slurred speech, imprecise consonants, and dysfluencies. I had this experience with my mother all of the symptoms above - then she was given a flouraquinolin antibiotic & she went into full blown hallucinations - a reaction that some elderly have to this class of drugs. Neurological Nov 27, 2022 · Voice problems are often mild and can be treated at home, but sudden speech problems are more likely to need urgent medical care. A massive increase in the prevalence of both is evident from the age of 65 years. The cerebellum is located at the base of the brain and connects to the brainstem. The sudden onset of slurred speech can be a sign of stroke. Ataxia is caused by damage to the part of the brain called the cerebellum or its connections. She first noticed the symptoms 3 weeks earlier, and associated it with fatigue. Jun 1, 2023 · Stroke: A stroke can cause sudden onset confusion, and it can look a lot like delirium. Other symptoms include: Difficulty moving the mouth, tongue, or lips. It can arise due to various underlying factors. Medication reactions may also be a cause of these symptoms. Dec 7, 2023 · How speech changes depends on the type of dysarthria. Download PDF Key Points One of the most common problems of older people. Common causes of dysarthria include conditions that affect the nervous system or that cause facial paralysis. Summary. Jul 12, 2024 · Dysarthria happens when the muscles used for speech are weak or are hard to control. But more than half of the people with FTD have no family history of dementia. One of the primary causes of slurred speech is a stroke. When to visit a Doctor? When dysarthria or sudden slurred speech occurs, it can be an indication of a serious underlying health condition that requires immediate medical attention. Learn more about how high blood pressure can lead to a stroke and its early signs here. Slurred speech is when there is a disconnect between the motor functions of the brain and the mouth Apr 26, 2024 · Sudden confusion is a serious condition that demands immediate medical care. Though such speech issues are frustrating, they aren’t permanent. Speech therapy can also involve caregivers and loved ones, so they know how best to communicate with and help you. Altered mental status (AMS) can present as changes in consciousness, appearance, behavior, mood, affect, motor activity, or cognitive function. Jan 23, 2020 · Post-operative delirium affects up to 50% of older adults, causing agitation and confusion after surgery. While many cases of dysarthria are caused by muscle mass loss, there are many other medical issues that could lead to slurred speech. What other signs and symptoms are MOST likely to occur in this client Dec 22, 2021 · A Sudden Voice Change in Elderly Patients . But many times, it will usually have other neurologic symptoms. , talking too quietly or too loudly); rapid or unusual speech rhythm that is difficult to understand; a sudden onset of a high pitched nasal voice; monotone speech; and difficulty moving the tongue or facial muscles. Doing so will help them express their feelings without being frustrated. Abnormally low blood pressure Dec 14, 2020 · There are a number of causes of nausea or vomiting, including gastroenteritis or food poisoning. 1 – 3 Recent changes are the focus of this article May 11, 2022 · Dysarthria is a speech disorder caused by brain damage. Her radial pulse is palpable but grossly irregular. Jan 6, 2025 · The signs and symptoms of dysarthria include slurred and slowed speech; inconsistencies in volume of speech (e. What is an example of dysarthria speech? The main symptom of dysarthria is unclear speech. . This connection highlights the importance of considering mental health when evaluating speech difficulties. Sudden unusual vocal symptoms require prompt medical attention. Dec 17, 2022 · An abnormal growth of tissue and the brain can cause headaches, slurred speech, seizures, and personality changes. Mar 8, 2021 · While mild speech problems may be associated with the aging process, these should not be dismissed as trivial. Always seek medical care straightaway for slurred speech. The case of an elderly man, who demonstrated voice changes and later swallowing impairment with weight loss, is reported. Early speech therapy can sometimes help with diagnosis, as subtly different speech problems can indicate different causes. In frontotemporal dementia, the frontal and temporal lobes of the brain shrink and certain substances build up in the brain. Sudden confusion can be caused by many different things. Has many causes that often overlap including Nov 28, 2023 · Causes. refer imediately adults with sudden-onset speech or language disturbance to have an assessment for a vascular event, in line with local stroke/TIA pathways. Confusion and agitation. Feeling tired or stressed. The medical community isn’t sure why UTIs cause confusion in older people. Some common causes of dizziness in elderly people include: Problems with the inner ear; Poor blood circulation; Medication side effects; Anxiety disorders; Neurological conditions, like Parkinson’s According to Dr. Nov 24, 2020 · What causes slurred speech in elderly ( dysarthria )? Slurred speech and dizziness may be caused by dysarthria. What Causes Bad Headaches in Elderly People? Headaches range from mild to severe and can be categorized into two basic types. Next, the researchers defined the group of symptoms that fall under "nonconsensus TIAs": dizziness with no other symptoms; thick or slurred speech; abnormal or clumsy gait; double vision or loss of vision in both eyes Feb 18, 2023 · Medications are one of the most common causes of delirium, including opioids, anti-seizure drugs, steroids, and anxiolytics. She responds to painful stimuli with decorticate posturing and has snoring respiration at a rate of 10 per minute. The effects last a few minutes to a few hours and fully resolve within 24 hours. Seek immediate medical Jun 5, 2023 · Dysarthria is a neuromotor disorder that results from abnormalities in speed, strength, accuracy, range, tone, or duration required for speech control. Understanding the different causes of speech problems and the loss of speech in the elderly is important for making sure your senior loved one receives the care they need. Cognitive impairment linked to brain injuries, such as memory loss, can disrupt meaningful communication. Slurred speech. slurred speech or difficulty speaking coherently Jul 26, 2019 · Summary points from NICE guidance relating to speech, swallowing and language problems in adults are: Sudden-onset speech or language disturbance. Aphasia usually happens suddenly after a stroke or a head injury. 4. In this article, we will explore six common causes of slurred speech related to neurological disorders. This severely disrupts normal circulation of blood. Also known as delirium, sudden confusion causes changes in an older adult’s behavior and alertness. Progressive slurred or disrupted speech Aug 14, 2019 · slurred speech What are the underlying causes of confusion? There are a number of factors that can cause confusion, from serious health problems to vitamin deficiencies. Common causes include: stroke – the most common cause of aphasia Jul 1, 2011 · A 54-year-old right handed woman presented to the emergency department with complaints of slurred speech and right foot heaviness. Jun 24, 2021 · Psychosis in Elderly & Dementia. ” While involvement of oropharyngeal musculature has been described with symptoms of dysphagia and slurred speech, the presence of fluctuating dysphonia as the first symptom of late-onset MG has not been emphasized. Possible causes include: Certain medicines or medicine side effects Sep 13, 2024 · It can disrupt speech control, causing difficulties with articulation, fluency, and rhythm. Mar 12, 2022 · Other causes of dementia include: Huntington’s disease: A single defective gene causes this brain disorder. Dec 12, 2023 · What Is the Treatment and Management of Speech Problems in the Elderly? 1. Slurred speech can be related to neurologic conditions including stroke. But yesterday it happened twice. Mar 12, 2024 · Slurred speech is a term used to describe imprecise articulation or decreased articulatory accuracy and clarity when speaking. Affected speech is due to increased muscle tension, racing thoughts, panic attacks, dry mouth, and concentration difficulties. For example, most instances of a shaky voice in elderly patients is a condition of the larynx called spasmodic dysphonia. Consequently, dementia psychosis elderly patients are at greater risk of having their delirium overlooked. Apr 1, 2017 · A retired 80-years-old man presented to the emergency department after 10 days of increasing polydipsia, polyuria, dry mouth, confusion, and slurred speech. How is sudden confusion defined? Apr 26, 2024 · Sudden confusion is a serious condition that demands immediate medical care. In a TIA, unlike a stroke, the blockage is brief and there is no permanent damage. Call 911 for sudden slurred speech or any of these other stroke symptoms: numbness or weakness on one side of the body; sudden change in vision, loss of vision, or eye pain What Causes Sudden Confusion in Elderly? In this blog, we explore sudden confusion and hallucinations in the elderly, delving into their common causes such as UTIs, dehydration, and medication side effects. Dementia is a group of brain disorders marked by significant cognitive impairment to the point that it affects the patient’s daily living. Hearing Loss Feb 5, 2022 · Sudden confusion, sometimes called delirium or encephalopathy, can be a sign of many health problems. 3. Learn more. Jun 25, 2024 · Dysarthria is a speech disorder that results from weakness in the muscles involved in speaking. Loss of coordination. Inability to keep both arms lifted. Contact your doctor any time you are worried about your Some people are unaware that their speech makes no sense and get frustrated when others don't understand them. Symptoms of vascular dementia include: confusion; slurred speech; problems thinking or remembering. Oct 18, 2021 · Brain infections such as encephalitis or meningitis are further possible causes. Signs of psychosis in elderly persons include agitation, hallucination, slurred speech, mood swings, uncooperative behavior, agitation, and a handful of other symptoms that are easily mistaken for dementia. Furthermore, the findings of this review cannot be applied to all cases of UTI because the clinical presentations vary among the elderly population. When it comes to tackling slurred speech, the first step is understanding what we’re up against. But a TIA does not last as long as a stroke. Jun 11, 2022 · It can impact your speech, as well as the way you write and understand both spoken and written language. Her speech is coming back, but we're having a speech therapist out now. Our brains are constantly sending tiny electrical Nov 20, 2020 · If an elderly loved one starts to behave in an unusual way, especially during the evening, seeking medical attention is recommended. Time: Call 995 immediately if your elderly loved one shows any of the above symptoms. Study with Quizlet and memorize flashcards containing terms like Hypoglycemia is characterized by, An elderly male client with a history of high blood pressure and coronary artery disease complains of sudden loss of vision in one eye and a severe headache. Apr 8, 2024 · Sometimes, the causes of speech problems can be solved by medication and alternative therapy methods. Feb 9, 2024 · Causes. How is sudden confusion defined? This can cause sudden symptoms similar to a stroke, such as speech and visual disturbance, and numbness or weakness in the face, arms and legs. Speech: Slurred speech or sudden trouble speaking or understanding is one of the common symptoms of a stroke. Other symptoms include: Sounding as though they are mumbling; Speaking softly or in a whisper; Speaking in a nasal or stuffy, hoarse, strained, or breathy voice; A person with dysarthria may also drool and have problems chewing or swallowing. When speech is disrupted, stress or anxiety increases, worsening the symptoms. Left untreated, it poses long-term health risks. Do not try to self-diagnose. SeniorHomeSeeker Dementia. Anarthria is the severe form in which there is a complete Aug 8, 2023 · Headaches in the elderly may be a symptom of a more serious medical condition, so we will look at some of the symptoms that can cause a headache in elderly people and determine when to seek medical intervention. Dec 10, 2017 · To make a diagnosis of vascular dementia, the symptoms must represent a decline from one’s prior level of functioning, confirmed with objective pencil and paper tests, and be due to strokes. Aphasia is caused by damage to parts of the brain responsible for understanding and producing language. Sudden onset over hours to days; Slurred speech and language difficulties, talking that doesn’t make sense; Changes in feeling (sensation) and perception; Easily distracted, decreased attention, concentration, and awareness of what is nearby; Usually more alert in the morning than at night; in and out of consciousness Mar 21, 2022 · Slurred speech can be a symptom of a stroke, drug overdose, brain injury, or another condition. Still, other undiagnosed underlying causes of delirium in hospitalized patients may make the diagnosis of UTI an incidental finding or association. Nov 26, 2024 · Most cases of delirium are either hyperactive or hypoactive. Hypoactive delirium causes people to move or speak very slowly, seeming exhausted and zoned out. Dec 15, 2014 · Vascular dementia can also develop after a person has a major stroke . Jan 5, 2018 · Elderly: Causes, Symptoms, and Treatment Asa Oxner, MD -Slurred Speech-Unable to move arm or leg-Sudden loss of vision. Some of the most common causes of sudden confusion include: an infection – urinary tract infections (UTIs) are a common cause in older people or people with dementia Jun 21, 2023 · Our 97 year Mom with severe dementia and has no other major health concerns but macular degeneration and some arthritis. Sep 29, 2023 · These speech problems can range from mild challenges to severe impairments in communication. 2. Understanding the causes of slurred speech is crucial in order to seek appropriate medical attention and treatment. It also causes pain, exhaustion, and shortness of breath, all of which interfere with speech. Classes of medications more frequently implicated in causing dysarthria include: Anti-seizure medicines; Barbiturates Dec 6, 2023 · It can be caused by various factors, including neurological disorders. There are three major groups of ataxia causes: acquired, degenerative and hereditary. But silent strokes don’t show symptoms like these. Although, in dementia patients, the lower baseline for clear thinking and effective communication is likely a contributing factor. Voice problems are caused by changes in a person’s vocal cords Oct 14, 2022 · Causes. What is epilepsy? Epilepsy is the name for a brain condition that causes a person to have two or more seizures. , stroke, brain injury), degenerative diseases (e. Jul 11, 2024 · This cognitive impairment can contribute to both slurred speech and feelings of fatigue. Symptoms of a transient ischaemic attack (TIA) Cerebrovascular insults and neurodegenerative diseases are the main causes of acquired speech and language disorders. In fact, silent Age-related Dizziness and Imbalance This information is intended as a general introduction to this topic. Slurred Speech Depression: A Lesser-Known Connection: While not as widely recognized, slurred speech can be a symptom of severe depression. Do not drive to the hospital or let someone else drive you. Jan 12, 2024 · Let’s learn more about the causes of seizures in elderly people, how they are treated, and the outlook. Dysarthria Articulation Treatment Ideas. In this post, we explore common causes of slurred speech, emphasizing the importance of understanding these factors for obtaining effective intervention. It comes on quickly, within hours or days. These conditions may cause tongue or throat muscle weakness. Mixed dysarthria includes a mix of two or more of the other five types. jvutjx kdhurj eonvnk rspmae gkypnh jsbfia cxdj witzs epxflx fmdtd