Showing papers on "Dysarthria published in 1993"

Speech and oromotor deficits of epileptic origin in benign partial epilepsy of childhood with rolandic spikes (BPERS): relationship to the acquired aphasia-epilepsy syndrome

Abstract: The authors report three children who suffered temporary oromotor or speech disturbances as focal epileptic manifestations within the frame of benign partial epilepsy of childhood with rolandic spikes and review similar cases described in the literature. The deficit can occur as an initial symptom of the disorder without visible epileptic seizures and interferes in a variable way with simple voluntary oromotor functions or complex movements including speech production, depending on the exact location and spread of the discharging epileptic focus around the perisylvian region. The most severe deficit produces the anterior operculum syndrome. More subtle non-linguistic deficits such as intermittent drooling, oromotor apraxia or dysfluency, as well as linguistic ones involving phonologic production, can occur. The rapidity of onset, progression and recovery of the deficit is very variable as well as its duration and presumably reflects the degree of epileptic activity. In some cases, rapid improvement with antiepileptic medication occurs and coincidence between the paroxysmal EEG activity (which is usually bilateral) and the functional deficit is seen. The clinical and EEG profile of the seizures disorder and the dynamic of the deficit in these cases bear a strong resemblance to what is seen in the acquired epilepsy-aphasia syndrome (Landau and Kleffner). The variations in clinical symptoms appear more related to the main site, local extension and bilaterality of the epileptic foci rather than a basic difference in physiopathology.

Neurological andadrenal dysfunction intheadrenal insufficiency/al acrima/achalasia (3A)syndrome

Abstract: Reviewof20patients withglucocorticoid deficiency (three casesalsowithsaltloss) associated withabsent tearsecretion (19 cases) andachalasia ofthecardia (15cases) revealed neurological abnormalities in17 including hyper-reflexia, muscleweakness, dysarthria, andataxia together withimpaired intelligence andabnormal autonomic function, particularly postural hypotension. Thesefindings indicate that significant neurological problemsarecommoninthis multisystem disorder. (Arch DisChild 1993; 68:779-782)

Perceptual analysis of speech disorders in progressive supranuclear palsy

Abstract: We used oral motor examinations and quantitative perceptual speech analysis to study deviant speech dimensions in 44 patients with progressive supranuclear palsy (PSP). All patients had dysarthria with variable degrees of spasticity, hypokinesia, and ataxia; 28 patients had all three of these components, and 16 patients had only two components. Twenty-two patients (50%) had predominantly spastic components, 15 (34%) had predominantly hypokinetic components, six (14%) had predominantly ataxic components, and in one (2%) the spastic, hypokinetic, and ataxic components were equal. Stuttering occurred in nine patients (20%) and palilalia in five (11%). The finding of a mixed dysarthria with a combination of spastic, hypokinetic, and ataxic components might assist in diagnosis and is consistent with the widespread neuropathologic changes found in PSP.

A case of foreign accent syndrome without aphasia caused by a lesion of the left precentral gyrus

Abstract: We report a case of foreign accent syndrome (FAS) without aphasia. The patient was a right-handed, 44-year-old woman, a native Japanese. Disposition and inversion of pitch accents and appearance of unnecessary stress accents made her speech sound foreign, like that of a Korean. MRI demonstrated an infarction in the middle fifth of the posterior lateral aspect of the left precentral gyrus. Limited motor cortex damage causes FAS without dysarthria, apraxia of speech, or aphasia.

Aspects of disturbed prosody in dysarthria

Abstract: It is well known that disturbed prosody is a symptom which can be observed in all types of dysarthria. However, there is no standardized way of assessing disturbed prosody in dysarthria quantitatively. This makes it difficult or impossible to study the efficacy of treatment. In this study the following aspects of prosody were analysed in the spontaneous speech of 84 dysarthric patients and of 154 normal controls: length of tone units, fundamental frequency, and standard deviation of fundamental frequency. The results revealed significant differences between normal controls and dysarthric patients on the one hand, and between severely and mildly dysarthric patients on the other hand: severe dysarthrics have shorter tone units and higher mean fundamental frequencies than mild dysarthrics and normal controls. Patients with mild dysarthria have lower standard deviations of fundamental frequency than normal controls and severely disturbed patients, i.e. their speech is more ‘monotonous’. The variables analysed...

Severe disturbances in speech, swallowing, and gait following stereotactic infrathalamic lesions in Gilles de la Tourette's syndrome

Abstract: A 40-year-old man with severe Gilles de la Tourette9s syndrome characterized by forceful self-injurious motor tics, coprolalia, and obsessive-compulsive disorder had bilateral anterior cingulotomies and bilateral infrathalamic lesions placed stereotactically during two neurosurgical procedures. During the second procedure, the patient acutely developed a marked dysarthria. Postoperatively, he manifested a severe gait disturbance with postural instability, bradykinesia, axial rigidity, micrographia, and a profound swallowing disorder. MRI showed asymmetric (left > right) low-density areas in an infrathalamic region as well as low-density areas bilaterally in the anterior cingulate gyri. Although the patient9s tic and obsessive-compulsive symptoms improved, the self-injurious motor tics along with other motor and phonic tics have recurred. The patient9s speech remains largely unintelligible 8 months following the last surgical procedure, and the other neurologic deficits remain unchanged.

Clinical assessment of dysarthria: Performance on a dysarthria test by normal adult subjects, and by individuals with Parkinson's disease or with multiple sclerosis

Abstract: The study reports the results of a clinical dysarthria test procedure applied to a group of 59 normal subjects, and two patient groups: 30 individuals with Parkinson's disease (PD) and 30 with multiple sclerosis (MS). The assessment protocol consists of 54 test items divided into 6 subtests—Respiration, Phonation, Oral motor performance, Articulation, Prosody and Intelligibility. The test procedure generated statistically significant differences between a) normal adult subjects and each of the two neurological subject groups; b) normal adult subjects and individuals with dysarthria; and c) normal adult subjects and individuals with MS who did not show any audible signs of abnormality in continuous speech.

Syllabic Timing in Dysarthria

Abstract: A new, intensity-based method of measuring syllable duration was used to assess syllabic timing in 75 patients with dysarthria of predominantly traumatic and cerebro-vascular origin and in 30 norma...

Speech Motor Control in Parkinson’s Disease: A Comparison between a Clinical Assessment Protocol and a Quantitative Analysis of Mandibular Movements

Abstract: Nine individuals with Parkinon’s disease (PD) and nine normal control subjects, matched for sex and age, were compared on a standardized assessment protocol for dysarthria. Simple measures of hand and

Dysarthria in Friedreich's ataxia: Timing of speech segments

Abstract: Under certain conditions Friedreich's ataxia (FA) can be considered a model of afferent cerebellar dysfunction. In seven subjects suffering from FA acoustic analysis of sentence utterances, including durational measurements of syllables and intrasyllabic segments, was performed. The FA patients presented with prolongation of syllable, vowel and occlusion lengths. Furthermore, they showed less durational contrasts between stressed and unstressed syllables. These abnormalities may be explained by a slowing of articulatory movements. In contrast, the voice onset time (VOT) values and the variation coefficients of the segments considered were not consistently increased. With respect to interarticulatory coordination, thus, a specific timing deficit could not be disclosed in FA dysarthria. These results are discrepant to data obtained with syllable repetition tasks, as reported in the literature. Obviously, the motor control of sentence utterances differs from that of syllable repetitions. There is psycholingu...

Hypernasality in dysarthric speakers following severe closed head injury: a perceptual and instrumental analysis

Abstract: Hypernasality in the dysarthric speech of 20 severely closed-head- injured (CHI) subjects was investigated using both perceptual and instrumental techniques. A perceptual analysis of the speech of the CHI subjects was performed using a four-point rating scale for hypernasality. Instrumental assessment was carried out using a computerized accelerometric technique yielding a nasal coupling index. Results revealed a high incidence of perceived hypernasality (95%) in the speech of subjects in the CHI group. More than half of these subjects exhibited hypernasality of speech to a moderate to severe degree. When compared with a control group matched for age and sex the severely CHI subjects were perceived as being significantly more hypernasal. Instrumental assessment revealed that the functioning of the velopharyngeal valve in the group of CHI subjects was significantly impaired compared to the control group. The study highlighted the need to evaluate the perceptual and instrumental assessment results for the s...

A statistical causal model for the assessment of dysarthric speech and the utility of computer-based speech recognition

Abstract: The evaluation of the degree of speech impairment and the utility of computer recognition of impaired speech are separately and independently performed. Particular attention is paid to the question concerning whether or not there is a relationship between naive listeners' subjective judgments of impaired speech and the performance of a laboratory version of a speech recognition system. It is a difficult task to relate a speech impairment rating with speech recognition accuracy. Towards this end, a statistical causal model is proposed. This model is very appealing in its structure to support inference, and thus can be applied to perform various assessments such as the success of automatic recognition of dysarthric speech. The application of this model is illustrated with a case study of a dysarthric speaker compared against a normal speaker serving as a control. >

Dysarthria in bilateral thalamic infarction. A case study.

Abstract: A patient suffering from bilateral thalamic infarction in the region supplied by the paramedian arteries sparing the internal capsules underwent acoustic analysis of sentence utterances. The results were compared with the findings obtained in parkinsonian subjects, in patients with upper motor neuron lesions, and in normal subjects. Acoustic measurements revealed increased pitch, monotonous speech, rough voice quality, and normal speech tempo concomitant with articulatory impreciseness in terms of incomplete closure productions. This constellation resembled parkinsonian dysarthria. Damage to the thalamic projection area of the pallidal efferents, therefore, seems to be the most probable cause of the patient's speech disorders. In parkinsonian subjects stereotactical lesions of this structure ameliorate rigor, but not akinesia. Thus, our patient's speech deficits, and by analogy the corresponding parkinsonian dysarthric disturbances, may be considered akinetic signs.

The Whitaker database of dysarthric (cerebral palsy) speech

Abstract: The Whitaker database is a collection of 19 275 isolated‐word utterances spoken by six persons whose speech spans a broad spectrum of dysarthria due to cerebral palsy. The database additionally contains utterances by a normal speaker which can be used for reference. The vocabulary is divided into two sets—one of 46 words (the ‘‘TI‐46’’ vocabulary consisting of the alphabet, digits, and 10 control words), the other of of 35 words (the ‘‘Grandfather’’ set consisting of phonetically diverse words). The database is available through the electronic mail network for use in studies of recognition, perception, articulation, and other aspects of speech disorders.

Measuring segmental timing in pathological speech using electropalatography

Abstract: Electropalatography (EPG) was used to provide quantitative data on the duration of speech segments, defined in terms of lingual-palatal contact patterns, for four normal-speaking subjects and six pathological speakers. The experimental group all presented with speech disorders thought to be the result of neurological damage or defect. The differences between the normal and speech-disordered subjects demonstrated clearly the lack of control over segmental timing in neurological pathological speech.

Abnormal patterns of speech breathing in dysarthric speakers following severe closed head injury

Abstract: The respiratory abilities of a group of 20 subjects with a speech disorder resulting from severe closed head injury (CHI) were assessed using both spirometric and kinematic techniques and compared with those of a group of 20 non-neurologically impaired controls matched for age and gender. Results of the spirometric assessment showed that the CHI subjects as a group had lower vital capacities and lower forced expiratory volumes 1 second than the controls. Kinematic assessment also showed that the CHI subjects had problems co-ordinating the action of the rib-cage and abdomen when carrying out speech tasks such as vowel prolongations, syllable repetitions and reading. Results are discussed in terms of the effects of CHI on neuromuscular function.

No place for motor speech acts in the assessment of dysphagia? Intelligibility and swallowing difficulties in stroke and Parkinson's disease patients.

Abstract: Speech and language therapists are increasingly being asked to treat dysphagic patients. Concern has been expressed and surveys have confirmed that radiological assessment procedures are rarely available. Consequently, patients must often be assessed and their treatment planned on the basis of bedside examinations. Despite evidence that swallowing disorders need not be related to problems of articulation, recommendations on the procedure of such examinations frequently include an evaluation of speech and non—speech articulatory movements. A study is reported of patients who exhibit both dysphagia and dysarthria as a result of either stroke or Parkinson's disease. Assessments of the intelligibility of their speech and of their swallowing problems were found to be unrelated. The implications of this finding for the assessment of dysphagia are discussed.II est de plus en plus frequent qu'on demande aux orthophonistes de trailer des sujets souffranl de dysphagie. Ceci n'a pas manque de soulever des inquietude...

Speech rehabilitation in dysarthria.

Abstract: Although the usefulness of speech rehabilitation in disorders such as asphasia is now recognized, many clinicians estimate that speech treatments for dysarthrics are of limited value. The conceptual approach to dysarthrias is a physiological approach that emphasizes the component-by-component analysis of the peripheral speech mechanism. The selection and sequencing of treatment procedures follow directly from the physiological nature and severity of involvement in each component.

Symptomatology of language disorders in cerebral palsy with mutism

Abstract: Language disturbances in cerebral palsy with mutism. The analysis of the afferent side of language in 18 cerebral palsy children with no oral expression shows that they form a very heterogeneous population. The semiological analysis concerning comprehension leads to their classification into four main groups akin to the classical dysphasia syndromes. ― Major agrammatism occurring in phonologico-syntactic dysphasis. ― Sensory dysphasias (or verbal deafness). ― Mixed (or global) dysphasias. ― Motor dysphasias: phonological programmation disturbances (anarthria) and motor production disturbances (dysarthria). The disclosure of these various dysphasias allows for specific rehabilitation and for education procedures suitable for each individual patient

Pediatric dysphasia. 1. The concept and clinical aspects

Abstract: This survey deals with the early diagnosis and treatment of children with developmental dysphasia, which may prevent the progression of learning and behavior disorders. In the pre-verbal and early verbal stage, the severity of the clinical picture is primarily determined by concomitant motor pathology (motor dysfunction, dysarthria, general and oral dyspraxia) and by receptive pathology (hearing and auditory perception). In the verbal period, linguistic problems start to play a role, and often combine with oral motor symptoms to present a mixed picture. Various language syndromes do not become clear until some time later. After the kindergarten period, the oral motor and perceptual problems decrease and the language disorders continue to play a role and influence the child's conversation, internal speech reading and spelling at school. In a relatively small number of children without oral motor, perceptual or memory problems, there can be a basic syndrome of "pure dysphasia" without any other neurological signs. In somewhat more than half the patients, the basic syndrome of pure dysphasia is accompanied by other neurological signs. Treatment should not be confined to speech therapy techniques, but can only be optimally given by a highly trained team whose expertise also extends to the schooling aspect.