Speech disorders include aphasia and dysarthria, which usually manifest as inability to speak, slurred speech, incoherent speech, incoherent answers and labored speech. The reason is simple, because the language center is located in the brain, language expression and understanding are done by specific parts of the brain, and the articulatory organs and muscles are also controlled by the cerebellar brainstem. Speech disorders accompanied by numbness and weakness of limbs and confusion are easier to diagnose, but may not be easy to determine when they occur alone. Last week, two patients were misdiagnosed in the emergency department with cerebral infarction. A middle-aged male with sudden onset of slurred speech for 3 hours, no previous hypertension or diabetes, history of smoking and alcohol abuse, no other positive neurological signs on physical examination except slurred speech, no significant abnormalities on cranial CT, talking and walking like alcohol, but denied drinking and smelling alcohol, followed up with medical history that he took “alprazolam 3 tablets” 5 hours ago due to insomnia. “Alprazolam 3 tablets”, alprazolam is a benzodiazepine hypnotic sedative and anxiolytic, that is, and common Valium is a class of drugs, common adverse reactions are drowsiness, dizziness, weakness, etc., high doses occasionally see ataxia, tremor, urinary retention, jaundice. Rarely, there are rash, photosensitivity, leukopenia. Individual patients experience euphoria, polysynthesis, sleep disturbance, and even hallucinations. These symptoms disappear quickly after stopping the drug. A few patients have dry mouth, mental inattention, excessive sweating, palpitations, constipation or diarrhea, blurred vision, and hypotension. Moreover, the patient’s speech slurred since the onset gradually improved without other signs, so cerebral infarction was excluded and considered as a side effect of alprazolam. The other case was a middle-aged female with sudden inability to speak for 12 hours, previous hypertension, uncooperative on physical examination, clear consciousness, incoherence, auditory comprehension impairment, weakness of limbs, no obvious hemiparesis and pathological signs. A cranial CT showed an old cavernous infarct in the left basal ganglia region. The patient had both motor and sensory aphasia, and the center of motor speech is in the frontal lobe, while the center of sensory speech is in the temporal lobe, if it is a cerebral infarction, the lesion is larger, and both frontal and temporal lobes are involved, but the patient was not conscious and had obvious limb movement disorder, which is not clinically consistent. The diagnosis of dysthymia, the diagnosis of disease history symptoms signs as well as not less.