Sudden Texting Impairment in Teenagers: A Case of Unexpected Text Messaging Incapacitation in Adolescents

Sudden Texting Impairment in Teenagers: A Case of Unexpected Text Messaging Incapacitation in Adolescents

Story of a teen's sudden, perplexing texting difficulties

Meet a 15-year-old lad, once hale and hearty, now lodged in the emergency room. For the past two hours, he's been unable to type a single coherent message on his phone. He knows exactly what he wants to write, knows the exact words, but the letters won't arranging themselves in a sensible order. For the past three days, he's been battling a fever and pounding headaches.

Strangely enough, he can still speak freely to his mom, pronounce words he can't type. He recognizes objects his mother shows him and can name them. But, thirty minutes after his arrival at the ER, things go south fast. He can no longer identify objects, even though he talks fluently. His temperature remains a sweltering 39°C.

This teenager suffers from dystextia, a disorder identified around fifteen years ago, which makes it tricky or impossible for some to write messages on a mobile phone. It's linked to damage in the brain regions associated with language. His dystextia is accompanied by an inability to name common objects (anomia) and an inability to write or type his name.

However, he can repeat phrases correctly, read a short text, and comprehend what he reads. No muscle weakness or coordination problems have been detected. His hands and fingers move precisely. Muscle strength and sensitivity are normal.

The initial biological exams (blood and liver tests) show no abnormalities. However, an MRI with contrast reveals several anomalies in the insular lobes on both sides, as well as in the frontoparietal regions of both hemispheres.

Analysis of the cerebrospinal fluid (CSF), collected by lumbar puncture, shows an increase in the number of white blood cells (lymphocytic pleocytosis) and protein levels (hyperproteinorachia). These CSF anomalies are observed in cases of meningitis inflammation. A multiplex PCR test reveals the presence of the herpes simplex virus type 1 (HSV-1), responsible for a serious infection called herpetic meningoencephalitis.

First known case of dystextia during a brain infection

"To our knowledge, this is the first time that a case of a teenager presenting febrile dystextia revealing a herpetic meningoencephalitis has been reported," state Florian Perrin de Brichambaut and his colleagues, pediatric neurologists and radiologists at Rouen University Hospital, in an article published in March 2025 in the European Journal of Neurology.

Treatment with the antiviral aciclovir (for 21 days), the antibiotic ceftriaxone (for 2 days), and the steroidal anti-inflammatory solumedrol (for 5 days) was administered promptly. The teenager's condition improved swiftly. In two days, he was once again typing messages on his phone without errors and penning a sentence without blunders.

Six weeks later, neuropsychological tests demonstrated that he possessed outstanding language and comprehension skills. The follow-up MRI showed some rare sequel lesions, tiny punctiform scars in the insular lobes.

This teenager struggled with dystextia, a condition that can manifest in various ways: slowed word formation, incoherent phrases, paraphasias (using words out of context), or verbal perseverations (inappropriate repetitions).

First identified in 2006 in a 40-year-old man after a small stroke, dystextia has since been reported in medical literature, notably after strokes, migraines, or tumors affecting specific brain areas, particularly the left insula. Other causes have been reported, such as in a 68-year-old Japanese woman with amyotrophic lateral sclerosis and frontotemporal dementia.

All these patients wrestled with, or were incapable of, writing messages on their phone: they composed their messages slowly, made mistakes, or created nonsensical phrases. These difficulties were usually accompanied by other language impairment signs, most commonly non-fluent aphasia, i.e., an alteration in the ability to produce words.

Caution is needed when medically analyzing poorly spelled text messages, as errors can stem from automatic spell-checks or predictive text systems. Moreover, spelling mistakes are often accepted in written messages, which can easily lead to a false impression of dystextia when no neurological disorder is present.

Typing a message on a phone relies on the integrity of motor, visual, and language function. However, the brain area that causes dystextia has yet to be pinpointed. "Based on reported cases of vascular origin, it appears that the posterior part of the left insula, vascularized by the anterior cerebral artery, is the most specifically involved area in this disorder. The insula appears to play a crucial role in transforming language into another form of communication, such as texting. In this teenager, both insular lobes were affected," the authors elaborate.

Rapid intervention is imperative

Dystextia is a language disorder that doctors are likely to spot more frequently in their practice given the widespread use of smartphones among adolescents. According to neurologists in Rouen, the basic clinical examination should include repeating a word and a phrase, naming five objects, writing a word or text message, and reading a short passage.

"An acute dystxtia episode constitutes a neurological emergency and should be treated like a stroke alert. An MRI should be conducted expeditiously," the authors sum up.

When dystextia reveals a stroke

A clinical case published in 2013 in the journal Neurology demonstrates that dystctia can reveal a stroke on its own. Neurologists from Henry Ford Hospital (Detroit, Michigan) detail the case of a 40-year-old man whose speech remained perfectly fluent while his written messages became incoherent.

His wife had received several text messages that, admittedly, were far from clear. The first, at 00:22, read: "Oh baby your ; "". A few seconds later, a second message followed: "I am happy ; "". Two minutes later, a third message appeared: "I am out of it, just woke up, can't make sense, I can't even type, call if ur awake, love you." This was, to put it mildly, strange. His wife described them as disjointed, incoherent, and difficult to understand.

The next day, at the hospital, the neurological exam revealed nothing abnormal, except for a slight weakness on the right side of his face. The standard language evaluation tests were unremarkable. Yet when the patient was asked to type a phrase on a smartphone, "the doctor needs a new Blackberry," he wrote: "Tjhe Doctor nddds a new bb." When asked to read his message back, he didn't spot any errors.

When Dystextia is Caused by a Tumor

This is not the first time French doctors have reported a case of dystextia. In 2020, neurologists at the Robert-Ballanger Intercommunal Hospital in Aulnay-sous-Bois presented the case of a 79-year-old patient who had recently developed language difficulties. It all started with difficulty finding the right words and locating the correct letters on the keyboard of her phone. This was accompanied by paraphasias, both orally and in writing: she would replace one word with another without realizing it. Furthermore, some words were distorted or unrecognizable, far beyond the scope of usual spelling mistakes, which was a stark contrast to her usual writing style, which always involved using complete and correctly spelled words.

An MRI suggested a tumor process. The pathological examination of the cerebral biopsy confirmed the diagnosis of glioblastoma, an aggressive brain tumor.

Dysdactylia: Difficulty Writing and Typing Texts Using a Keyboard

To conclude, it's worth noting that dystextia is not the only writing disorder in this digital age. Dysdactylia, also known as dystypia in English, refers to the inability to write and type texts on a computer keyboard.

The first case of dysdactylia, published in 2002, involved a 60-year-old man who had suffered an ischemic stroke, with a stoppage of blood circulation in an area of the left frontal lobe.

In 2024, Japanese neurologists described the case of a 48-year-old woman who had both dystextia and dysdactylia, but no aphasia (language disorder), following a stroke located deep within the brain (subcortical infarction).

The clinical distinction between dystextia and dysdactylia seems somewhat artificial, given that the touchscreens of mobile phones resemble computer keyboards quite a bit. Nevertheless, it's important to be able to identify dystextia or dysdactylia to precisely date the onset of symptoms and to reveal a cerebral pathology, whether it's of vascular, infectious, or tumoral origin.

If there's one thing to take away from these clinical cases, it's that these "modern" symptoms can appear at the onset of a stroke and often constitute the only clinical signs. So, if someone exhibits abnormal typing or sends incoherent text messages, immediately contact emergency services, as this could be a sign of a cerebral infarction.

For further reading:

• Perrin de Brichambaut F, Dupuy G, Sarda E, et al. Teenager Febrile Dystextia. Eur J Neurol. 2025 Mar;32(3):e70059. doi: 10.1111/ene.70059
• Hatakeyama M, Kanayama T, Tokunaga S, et al. A case of isolated dystextia due to subcortical infarction: a novel condition of the digital device era. BMC Neurol. 2024 Oct 5;24(1):374. doi: 10.1186/s12883-024-03892-w
• Adachi H, Numata J, Nishida K, et al. Dystextia and dystypia due to phonological errors after ischemic stroke: a case report in a Japanese patient. Neurocase. 2023 Apr;29(2):50-57. doi: 10.1080/13554794.2024.2345403
• Meeuwis IHM, van Rooijen EM, Verhagen WIM. The use of WhatsApp Messenger: an important tool in modern neurological examination. Acta Neurol Belg. 2020 Oct;120(5):1045-1049. doi: 10.1007/s13760-020-01435-x
• Gallardo-Molina N. Stroke in the 21st century: Dystextia and dystypia as indicators of neurological injury. Clin Neurol Neurosurg. 2020 Jul;194:105817. doi: 10.1016/j.clineuro.2020.105817
• Chevalier M, Belhedi N, Nahum-Moscovisci L, Corabianu O. Dystextia and dysdactylia, symptoms of the digital era: about a case. Prat Neurol FMC. 2020;11(4):260-265. doi: 10.1016/j.praneu.2020.08.003
• Sharma AK, Fridman S, Gleichgerrcht E, Sposato LA. Dystextia and dystypia as modern stroke symptoms: A case series and literature review. Clin Neurol Neurosurg. 2019 May;180:25-27. doi: 10.1016/j.clineuro.2019.02.001
• Maeda K, Shiraishi T, Idehara R. Agraphia in Mobile Text Messages in a Case of Amyotrophic Lateral Sclerosis with Frontotemporal Dementia. Intern Med. 2015;54(23):3065-3068. doi: 10.2169/internalmedicine.54.4982
• Al Hadidi S, Towfiq B, Bachuwa G. Dystextia as a presentation of stroke. BMJ Case Rep. 2014 Nov 20;2014:bcr2014206987. doi: 10.1136/bcr-2014-206987
• Burns B, Randall M. 'Dystextia': onset of difficulty writing mobile phone texts determines the time of acute ischaemic stroke allowing thrombolysis. Pract Neurol. 2014 Aug;14(4):256-257. doi: 10.1136/practneurol-2013-000509
• Ravi A, Rao VR, Klein JP. Dystextia: acute stroke in the modern age. JAMA Neurol. 2013 Mar;70(3):404-405. doi: 10.1001/jamaneurol.2013.6040
• Kaskar O, Patel K, Miller D, Angus E. Case Report: "Dystextia" as a Sole Manifestation of Expressive Aphasia in Acute Ischemic Stroke (P03.175). Neurology. 2013 Feb;80(7_supplement):P03.175.
• Ryu DW, Kim JS, Yang DW, et al. Dystypia without aphasia associated with visuospatial memory impairment in a patient with acute stroke. Alzheimer Dis Assoc Disord. 2012 Jul-Sep;26(3):285-288. doi: 10.1097/WAD.0b013e318231e614
• Otsuki M, Soma Y, Arihiro S, Watanabe Y, et al. Dystypia: isolated typing impairment without aphasia, apraxia or visuospatial impairment. Eur Neurol. 2002;47(3):136-140. doi: 10.1159/000047971

1. This teenager's sudden inability to text could be a sign of a neurological disorder known as dystextia.
2. science research indicates that dystextia is linked to damage in the brain regions associated with language.
3. Dystextia can manifest in various ways, such as slowed word formation, incoherent phrases, and paraphasias.
4. The first known case of dystextia during a brain infection has been reported, revealing a herpetic meningoencephalitis.
5. The herpes simplex virus type 1 (HSV-1) is responsible for herpetic meningoencephalitis, a serious infection.
6. Rapid intervention is imperative when dealing with a case of dystextia, as it can be a neurological emergency.
7. An MRI should be conducted expeditiously for a suspected case of dystextia.
8. Dystextia can be caused by a variety of medical conditions, including strokes, migraines, and tumors affecting specific brain areas.
9. Caution is needed when medically analyzing poorly spelled text messages, as errors can stem from automatic spell-checks or predictive text systems.
10. Typing a message on a phone relies on the integrity of motor, visual, and language function.
11. Based on reported cases of vascular origin, the posterior part of the left insula appears to be the most specifically involved area in dystextia.
12. The insula plays a crucial role in transforming language into another form of communication, such as texting.
13. Dystextia is a language disorder that doctors are likely to spot more frequently in their practice given the widespread use of smartphones among adolescents.
14. The clinical examination for dystextia should include repeating a word and a phrase, naming five objects, writing a word or text message, and reading a short passage.
15. Dystextia can reveal a stroke on its own, as demonstrated in a clinical case published in 2013.
16. Another writing disorder in this digital age is dysdactylia, also known as dystypia in English, which refers to the inability to write and type texts on a computer keyboard.
17. Dystextia is not the only writing disorder; dysdactylia has been reported, such as in a 68-year-old Japanese woman with amyotrophic lateral sclerosis and frontotemporal dementia.
18. Dystextia and dysdactylia seem somewhat artificial, given that the touchscreens of mobile phones resemble computer keyboards quite a bit.
19. The clinical distinction between dystextia and dysdactylia is important to precisely date the onset of symptoms and to reveal a cerebral pathology.
20. If someone exhibits abnormal typing or sends incoherent text messages, immediately contact emergency services, as this could be a sign of a cerebral infarction.
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