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I've had this odd stumble for years. If I put the heater fan on while driving it stumbles. Also if I hit the electrical windows up when they are already so putting a load on it it rpms drop and it stumbles. So seems like any big electrical load causes the stumble. In the winter when the truck is cold it's worst and as it warms up not so much. Any thoughts? Other then that it runs great 1990 F250 351 5 speed
Since I'm a simple guy, I look for simple stuff, at least at first. Thankfully, this actually works a lot of the time! I'd be inclined to look for loose, missing, or corroded grounds and cables, sometimes called bonding jumpers.
For example if that engine or transmission has ever been replaced/swapped out, it is very common for ground straps or bonding jumpers to be missing or left un-connected. They are all important, or they wouldn't be there, and Henry could have saved $.65 per unit sold. Poor grounds will cause some wacky stuff. Something is obviously interfering with the ignition.