Showing papers on "Dysarthria published in 1989"

Toward Phonetic Intelligibility Testing in Dysarthria

Abstract: The measurement of intelligibility in dysarthric individuals is a major concern in clinical assessment and management and in research on dysarthria. The measurement objective is complicated by the ...

Does cognitive impairment in Parkinson's disease result from non-dopaminergic lesions?

Abstract: In order to investigate the neuronal basis of cognitive disorders in Parkinson's disease, the neuropsychological performance of 120 patients with idiopathic Parkinson's disease was analysed in relation to motor symptoms as a function of their response to levodopa Cognitive impairment was poorly correlated with akinesia and rigidity, symptoms which respond well to levodopa treatment, and was not correlated at all with that part of the patients' motor score that could be improved by the drug In contrast, strong correlations were found between all neuropsychological test scores and axial symptoms such as gait disorder and dysarthria, which respond little if at all to levodopa treatment The neuropsychological test scores were also strongly correlated with the motor score of patients estimated when clinical improvement was maximal under levodopa treatment This score is assumed to represent residual non-dopaminergic motor dysfunctions The correlations suggest that much of the cognitive impairment in Parkinson's disease results from the dysfunction of non-dopaminergic neuronal systems

Speech manifestations in lateralization of temporal lobe seizures

Abstract: To evaluate the role of speech manifestations in lateralization of temporal lobe seizures, we reviewed videotapes of 100 complex partial seizures in 35 patients who underwent temporal lobectomy for intractable epilepsy. All patients had prolonged electroencephalographic video monitoring with scalp and subdural electrodes, and their speech dominance was determined with an intracarotid amobarbital test. Speech manifestations were observed in 79 seizures and were classified as vocalization, normal speech, or abnormal speech. Vocalization of sounds without speech quality occurred ictally in 48.5% of patients. Normal speech (identifiable speech) occurred ictally in 34.2% of patients. Abnormal speech (speech arrest, dysphasia, dysarthria, and nonidentifiable speech) occurred in 51.4% of patients, either ictally or postictally. Of all the above speech manifestations, only postictal dysphasia and ictal identifiable speech had significant lateralizing value: 92% of patients with postictal dysphasia had their seizures originating from the dominant temporal lobe (p < 0.001), and 83% of those with ictal identifiable speech had their seizures from the nondominant side (p = 0.013). This study shows that speech manifestations are common in complex partial seizures of temporal lobe origin and can provide an excellent clinical tool for lateralization of seizure onset.

Transient mutism following removal of a cerebellar tumor. A case report and review of the literature.

Abstract: A 14-year-old boy developed mutism 24 h after the removal of a vermian low-grade astrocytoma. The mutism was not accompanied by long tract signs or cranial nerve palsies. He started to regain his speech 3 weeks postoperatively, and 4 months after the operation he was minimally dysarthric. Seven similar cases of transient muteness following cerebellar operations and not accompanied by long tract signs or cranial nerve palsies have been reported in the literature. In most of them there was delayed postoperative onset of the mutism. In all patients the recovery of speech started to appear 2 weeks to 3 months postoperatively and passed through a dysarthric phase. The absence of long tract or other brain stem signs, together with the presence of dysarthria during the recovery of speech, suggests a cerebellar cause for the transient muteness.

Accurate non-word spelling despite congenital inability to speak: phoneme-grapheme conversion does not require subvocal articulation.

Abstract: Previous work has shown that children with motor speech disorders (dysarthria) have no particular difficulty in spelling non-words containing sounds that they cannot produce accurately in their own speech. This suggests that subvocal articulation is not implicated in generating a graphemic representation from a phonological string. However, it could be argued that, although severely unintelligible, dysarthric individuals may be able to use their own articulation as a basis for translating between phonemes and graphemes. In this study we investigated spelling of words and non-words in cerebral palsied individuals, including speechless (anarthric) as well as dysarthric subjects. Although spelling abilities of these individuals were below control levels, there was no evidence that different processes were used, and one anarthric individual achieved perfect performance in spelling a list of non-words which included consonant clusters. It is concluded that spelling by the 'indirect' route can be achieved in the absence of any articulation.

Posterior fossa tumours in childhood: Associated speech and language disorders post-surgery

Abstract: Six children aged between 6 and 16 years who had undergone surgery for the removal of a posterior fossa tumour were assessed at least one year post-operatively to determine the incidence and severity of any associated speech or language deficits. Five males and one female were included in the sample. The subjects were administered a battery of speech/language assessments including: a language screening test, an articulation test, a dysarthria assessment and a perceptual speech analysis. The results indicated that dysarthria and/or language impairment occurs in some cases subsequent to surgical removal of posterior fossa tumours. The occurrence of muteness immediately post-surgery would appear to indicate a poor prognosis for speech abilities. A possible link between the occurrence of long term language disabilities in these children and post-surgical radiotherapy is documented.

Die Dysarthrophonie des Parkinson-Syndroms

Abstract: Disorders of speech are a common and sometimes even the first symptom of parkinsonism. The various features of parkinsonian speech disorder include repetitive phenomena, disturbances of respiration, dysphonia, and impairment of articulation. This review aims at summarizing the neurological, phoniatric, and phonetical data regarding symptomatology, pathophysiology, and therapy of parkinsonian dysarthrophonia.

Paroxysmal dysarthria and ataxia: associated MRI abnormality.

Abstract: The clinical presentation of bitemporal field loss with a third nerve palsy was considered typical of a pituitary adenoma and this diagnosis was compatible with thc CT scan appearance. Involvement of the third nerve is common in large pituitary tumours due to either compression against the interclinoid ligament or invasion of the cavernous sinus.' The pathological finding was of an ependymoma involving the pituitary fossa. Although we cannot exclude the possibility that the tumour arose in the third ventricle and extended downwards into the sella, an intrasellar origin of an ependymoma may be possible. Ependymomas are primary glial tumours presumed to arise from a cell related to the ependymal lining.2 Although these tumours are usually related to the ventricular system, a connection with the ventricular ependyma could only be identified in six out of 14 cases in one series3 and primary ependymomas have been described in extra-axial soft tissue locations.45 The presence of either embryological remnants of the ependymal cleft within the sella or heterotopic ependymal lining cells may explain the unusual location of the ependymoma in our case. In a 10 week (45 mm) human fetus the neurohypophysis develops as an elongated outpouching of neuroepithelial cells which encloses a cavity that is continuous with the cavity of the neural tube.6 The infundibulum at this stage consists of undifferentiated ependymal cell precursors. The ependymal cleft is readily identified at 13 weeks (60 mm) but recedes by 16 weeks (1 12 mm) and is not present at birth. Isolated ependymal cells could be left behind in the infundibulum and neurohypophysis, as rests or heterotopias and these may undergo subsequent neoplastic transformation. We are not aware of any other similar examples of this very unusual presentation of a glial tumour.

Hemispheric mechanisms of motor speech

Abstract: A perceptual rating scale was used to evaluate the articulatory impairment of patients with suprabulbar, vascular lesions of the right (RHD, 35 patients) or the left (LHD, 35 patients) hemisphere. Both groups were matched for age, time elapsed since onset, lesion volume and lesion location. The amount and type of motor speech impairment differed significantly, resulting in hemispheric profiles of articulation. Slurring and rate reduction were the prominent features of left hemisphere dysarthria and dysprosody of the right. Verbal apraxia was found in six patients of the LHD group. Intrahemispheric correlations between dysarthria, lesion volume, and several hemispheric variables (orofacial apraxia, aphasia severity and visuospatial functions) did not exceed the 0–6 level. Most lesions causing hemispheric dysarthria were located in the basal ganglia, the cortical sensorimotor and opercular region. The observed lesion distribution and speech patterns implicate distinct hemispheric mechanisms of moto...

Aphemia associated with bilateral striato-capsular lesions subsequent to cerebral anoxia

Abstract: A case is presented of a 13-year-old right-handed male who exhibited bilateral striato-capsular lesions following an episode of cerebral anoxia and a range of clinical features typical of aphemia. The findings of a neurological assessment, neuroradiological assessment and battery of speech/language tests are described and their implications for current theories regarding the role of the basal ganglia in speech/language function discussed. The patient initially demonstrated an isolated loss of the ability to articulate words without the loss of the ability to write or comprehend spoken language. His initial mutism later resolved into a dysarthria with features similar to those seen in hypokinetic dysarthria. It was concluded that striato-capsular lesions in childhood are capable of producing temporary language disturbances and in some cases a persistent dysarthria.

Language disturbances after severe head injury: Do neurological or other associated cognitive disorders influence type, severity and evolution of the verbal impairment? A preliminary report

Abstract: Language disorders after severe head injury were studied in 30 young adult patients. The aim of the study was the identification of linguistic and neuropsychological patterns of traumatic language impairment. In addition to the Italian version of the Aachen Aphasia Test all patients were administered further neuropsychological tasks for the detection of associated attentive disorders, disorders of verbal memory and of language-related cognitive abilities. One third of the patients was classified as having aphasia, mostly of nonfluent type; another third showed only dysarthria. Most of the nonaphasic patients were, however, impaired in more sophisticated language-related or nonverbal tasks. Recovery after six to twelve months was studied in 18 patients. Improvement was more frequent in the standard aphasia test than for the language-related and neuropsychological tasks. No consistent correlation between age or duration of coma and the amount of improvement could be found.

Early intervention in amyotrophic lateral sclerosis: a case presentation

Abstract: Early intervention for managing the communication problems of a woman with ALS is described. Unique features of this intervention include the multiple approaches which were used as her motor speech problems became more severe and the “light tech” approaches used to meet her communication needs during the early course of her disorder.

[Dysphatic development: clinical importance and neurological background]

Abstract: The timely treatment of children with developmental dysphasia is important in the prevention of subsequent learning and behaviour disorders. The pathophysiology of developmental dysphasia is complex and depends on age. In the preverbal and early verbal phase the severity of the clinical picture is determined by accompanying motor function pathology (simple motor function, dysarthria, general and oral dyspraxia) and by receptive pathology (hearing, and auditory perception). In the verbal period linguistic problems become more prominent (syntax, morphology, semantics and verbal memory), these problems might be accompanied by oral motor symptoms. The different developmental language syndromes become more apparent with time. After kindergarten age the oral motor and perceptual problems diminish, but the language disorders, that influence communication and scholastic learning, remain. In a small number of children without oral motor, perceptual and memory problems, there exists a 'bare or nuclear syndrome', a so called 'pure dysphasia', without other neurological signs. In these children there is perhaps a genetically determined developmental disorder on a restricted neuronal level (no brain damage!). In more than half of the patients this syndrome is accompanied by other neurological signs, predominantly pointing to the left cerebral hemisphere. Furthermore there can be signs from the right cerebral hemisphere, the corpus callosum and from the afferent fibers systems for auditory perception. The nature and causes of these disorders are extremely variable, so that one cannot speak of the neural substrate or the pathogenesis. The diagnosis and the treatment can optimally only be performed by an experienced team, the expertise of which has to penetrate into the school education system.

Sprechstorung nach operativer entfernung eines linkshemispharischen zentroparietal lokalisierten glioms: kortikale dysarthrie oder sprechapraxie?

Abstract: A 38-year-old male patient with a deep central parietal lesion in the left hemisphere reveals a motor speech disorder but no aphasia as evidenced by linguistic testing with the Aachener Aphasietest. Nuclear magnetic resonance tomography of the brain shows no lesion of the brainstem. Whether the speech disorder can be termed cortical dysarthria or apraxia of speech is left open to discussion.

Disorder in the vocal tract and its detection from speech signal analysis

Abstract: The results of analyzing the speech signals of two patients with dysarthria are presented. The magnitude of misarticulation is quantized, and the pitch period variability is calculated using a Fourier search filter. The latter is a fast Fourier transform algorithm which searches for a narrow range of frequencies in the spectrum. An attempt is made to identify the malfunctioning muscles/nerves in the vocal tract. >