Showing papers on "Dysarthria published in 1983"

Aphemia. Clinical-anatomic correlations.

Abstract: • A syndrome of dysarthria following the appearance of small left frontal-lobe lesions has been recognized for many years but identified by numerous labels Varied terminology has led to confusion in the literature and inadequate recognition of this syndrome as a distinctive clinical entity We gathered clinical and anatomic (computed tomographic) data on four patients with this dysarthric syndrome and reviewed cases from the literature that contained sufficient clinical and anatomic data for comparison These patients had a distinctive syndrome of dysarthria without aphasia, caused by small lesions of the motor system for articulation: pars opercularis, inferior prerolandic gyrus, or white matter deep to those regions This syndrome should be distinguished from Broca's aphasia, Broca's area aphasia, transcortical aphasia, and subcortical aphasia Aphemia is not mild Broca's aphasia; it is severe dysarthria, at times in the setting of transient Broca's aphasia

Dysfluency (Stuttering) in Extrapyramidal Disease

Abstract: Acquired stuttering in the adult is rare and is usually associated with trauma or vascular disease. A recent patient had adult-onset dysfluency, and, subsequently, signs of progressive supranuclear palsy developed. A review of cases of extrapyramidal disease identified five parkinsonian patients with stutteringlike behavior. Dysfluencies were of slow onset and were an early symptom. Speech was characterized by repetitions/prolongations on initial syllables, which occurred on both small grammatical and substantive words. Dysfluency was found mostly in self-formulated speech. There was a positive adaptation effect. No secondary motor symptoms occurred and behavioral response to dysfluency was minimal. Speech characteristics of dysfluency associated with extrapyramidal disease differ from both developmental dysfluency and acquired dysfluency secondary to vascular or traumatic insults. In patients with adult-onset stutteringlike dysfluencies it is important to consider extrapyramidal disease.

Acquired capsular/striatal aphasia in childhood.

Abstract: • We studied a case of language loss caused by an acquired vascular lesion in the putamen, anterior limb of the internal capsule, and lateral aspect of the head of the caudate nucleus in a 7-year-old right-handed girl. Acute right-sided hemiplegia, mutism, oral apraxia, and disturbance in language comprehension but no dysarthria were present. During recovery, a nonfluent aphasia with anomia was evident. After six months, only mild hemiparesis and minor spelling difficulties persisted. We compared this patient with an 11-year-old right-handed girl with rightsided hemiparesis and dysarthria but no language loss following a lesion in the globus pallidus, a portion of the posterior limb of the internal capsule, and the body of the caudate. The presence of a language disturbance in the first but not the second patient was attributed to the difference in lesion location. The symptoms and lesions were similar to those in recent reports of adult patients. To our knowledge, this is the first report of these findings in a child with a left-hemisphere lesion.

Vocal Fold Paresis in Shy-Drager Syndrome

Abstract: Twelve patients with Shy-Drager syndrome (SDS) presenting symptoms of multiple nervous system atrophy and orthostatic hypotension were examined for laryngeal movement disorders and vocal impairment in speech. Vocal fold abductor paresis was found in 11 patients and was bilateral in 10. Speech task performance was recorded in SDS patients, Parkinson patients and age- and sex-matched controls. Trained listeners with inter-rated reliability greater than or equal to .85 judged each recording on 20 attributes while blind to speaker identity. SDS patients had a breathy and strained voice quality, reduced loudness, monopitch and monoloudness, imprecise consonants, variations in rate and rate-slowing, suggesting a flaccid type of dysarthria. In comparison with Parkinson patients, SDS patients had excess vocal hoarseness, intermittent glottal fry and a slow and deliberate speaking rate. Orthostatic hypotension, laryngeal stridor, hoarseness, intermittent glottal fry and slow speech rate were found to be discriminating symptoms of SDS.

Recurrent cerebellitis. A case report of a possible relationship with Epstein-Barr infection.

Abstract: A 52-year-old male noted a gradually developing dysarthria and ataxic gait. No fever or lymphadenopathy was observed, but hepatomegaly was present. A neurological examination revealed cerebellar speech, dysmetria, decomposition of the four limbs and an ataxic gait. Atypical lymphocytes were found in the blood and CSF. IgG antibody to EBV VCA was 320 x for serum and 8 x for CSF. The patient almost completely recovered several months after the onset, but he suffered a recurrence the following year.

Dysarthria and Apraxia

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