Lenguaje sin alteraciones

05:17 Jun 22, 2018 

Whatever this poor patient's condition, the phrase "lenguaje sin alteraciones" still has to mean that language function has not been affected. It's certainly not clear why the report would say this. Any neurological examination would immediately reveal the patient's speech defect.

00:15 Jun 22, 2018 

Arg!

23:24 Jun 21, 2018 

No puzzle; initial examination is normal, including language function. It is later on that acute signs of stroke are detected -as per neurological assessment.

* and yet, the neurological examination described in the OP does not correspond at all with a semi-conscious patient. That description is necessarily a prior examination as there are not any signs of stroke there. Patient might have been found semi-conscious at home, might have spontaneously recovered showing a normal (initial) neurological examination (as described) and later on might have developed the characteristic signs of a brain stroke.

23:15 Jun 21, 2018 

Well, then that is very puzzling. I can't see why they would write "lenguaje sin alteraciones" (no changes/alterations/abnormalities) when the person can't speak!

(It did make me wonder that a person would have normal speech after suffering a massive stroke. Also normal cranial nerves, no nystagmus, normal muscle tone and strength.)

23:13 Jun 21, 2018 

And later on, under EVOLUCIÓN Y COMENTARIOS, the doctor observes a "déficit neurológico severo con hemiplejia derecha, afasia mixta (lenguaje nulo) e imposibilidad para la deglución por el momento".

22:53 Jun 21, 2018 

I'm sorry, Joseph, Juan, I should have made this clear: he is paralysed throughout the right side and has lost the ability to speak. He couldn't speak when he was found having suffered the stroke, and he still can't, though he appears to understand what is said. That's why I don't think it can be "normal language function".

22:35 Jun 21, 2018 

Lenguaje sin alteraciones = Todo bien con el lenguaje.

22:30 Jun 21, 2018 

They're just testing language. You don't need to adhere too closely to the Spanish sentence construction; I think "normal language function" would be appropriate.