Dysarthria

About: Dysarthria is a research topic. Over the lifetime, 2402 publications have been published within this topic receiving 56554 citations.

A case of sigmoid colon cancer with temporary dysarthria associated with irinotecan

Abstract: A40 -year-old woman visited our hospital with adenocaricinoma of the sigmoid colon with multiple liver metastases and ovarian metastasis. Because of a stenosis of the primary tumor, she underwent a colostomy before chemotherapy. 5-fluorouracil and irinotecan and leucovorin(FOLFIRI)was selected as first-line chemotherapy. At the start of chemotherapy, just after the end of irinotecan and leucovorin administration, the patient developed dysarthria. There were no neurological abnormalities or hematological abnormalities. The treatment was temporarily discontinued, and the dysarthria completely disappeared within 90 minutes. 5-fluorouracil was administered after the disappearance of dysarthria. Within 60 minutes of the administration of irinotecan and leucovorin at the second chemotherapy treatment, the patient developed dysarthria again. The patient had no neurological or hematological abnormalities. Magnetic resonance imaging(MRI)showed no abnormalities. The treatment was stopped and dysarthria disappeared within 60 minutes as it did the first time. At each time, no treatment for dysarthria was performed. This patient refused to continue irinotecan because of dysarthria. Therefore, chemotherapy without irinotecan was continued for the third time onward. In the previous literature, 8 cases of dysarthria caused by irinotecan were reported as a rare toxicity. In all cases, dysarthria was temporary and reversible. Because the mechanism of dysarthria is unclear, specific treatment and precaution for dysarthria is not recommended. Since dysarthria is reversible, however, irinotecan might be continued until progression.

Speech and language dysfunctions in patients with cerebrocortical disorders admitted in a neurosurgical unit

Abstract: Introduction: Speech and language abnormality among brain injury patients are common, especially during the acute stage. The details of same from Andhra Pradesh (AP) state are limited. The present study provides details of speech and language abnormality among brain damage patients, from a tertiary care hospital AP. Materials and Methods: This study was conducted at tertiary care hospital, Nellore, AP. Patients with acute brain damage due to traumatic brain injury (TBI), cerebrovascular accident (CVA), and postoperative cases of brain tumors were selected for the study. Detail of speech and language disturbances was accessed using Western Aphasia Battery. All patients were right-handed and Telugu was their first language. Results: There were totally 38 patients, of them 28 had TBI, 8 patients were postoperative cases of brain tumor, and 2 cases were of CVA. The mean age was 45.6 years. A total of 22 patients were literate. TBI patients with left cerebral hemisphere damage manifested with anomic, conduction, transcortical sensory, global, and Wernicke's aphasia. Four patients of postoperative brain tumor manifested with anomic and transcortical sensory aphasia had left-sided brain damage and mild dysarthria had right-sided brain damage patient. CVA patients had anomic aphasia and subcortical aphasia having right and left cerebral hemisphere damage, respectively. Conclusions: This study reports that acute brain damage due to various causes manifest with speech and language abnormality, especially when the left cerebral hemisphere is involved.

Of cognition and cerebellum in SCA48.

Abstract: Sir, We read with interest the article recently published by Palvadeau and colleagues [1] where they report a new SCA48 family, confirming the complex phenotype of this disease, which combines ataxia with cognitive and behavioral symptoms [2], together with parkinsonism, chorea, and dystonia [3]. As a result, this last form of SCAmay be considered a Huntington’s disease-like syndrome. We recently reported a relatively large group of Italian SCA48 families [4]; if combined with the description of a new Turkish kindred and of the original Spanish family, it demonstrated that SCA48 recurs in the Mediterranean basin. It is worthwhile underlining that the Turkish and Spanish SCA48 patients harbored the same c.823_824delCT, and most of them presented with a similar cerebellar cognitive affective syndrome (CCAS), later followed by ataxia, hinting at possible genotype-phenotype correlations in SCA48. Interestingly, we also reported a woman harboring the very same c.823_824delCT in STUB1 (Pt 10, [4]), who presented at the age of 30 years with pure cerebellar symptoms, such as gait ataxia, dysarthria, mild dysmetria, and nystagmus. Later, the patient also developed cervical dystonia and mild choreic movements and, at age 60, mood-anxiety disorder and mild cognitive impairment. This case seems to suggest that genotype-phenotype correlations in SCA48 are rather loose. Demonstration of cerebello-frontal tracts involvement as potential substrate of CCAS is a stimulating finding. Nevertheless, we think that it is probably premature to define mental and behavioral dysfunctions in SCA48 as a pure CCAS, as well as to identify a specific structure as the main site of damage in this condition. In particular, we think that although very insightful when analyses are conducted at group level, the single-subject application of advanced imaging techniques should be taken with caution in conditions probably characterized by a complex pattern of alterations, due to the lack of standardization in terms of acquisition and processing [5]. Overall, and similarly to SCA17, SCA48 appears to be a widespread neurodegenerative disorder, encompassing cortical, subcortical, and infratentorial areas. In the majority of SCAs, cerebellar atrophy is an early event, whereas cognitive and behavioral features usually develop in late disease stages. In our SCA48 cohort [4], we observed cognitive impairment at onset only in two probands, and 4/11 affected individuals had no cognitive decline. Whilst we plaude Palvadeau and coworkers for the excellent work and the intriguing hypothesis presented, we believe that the relationship between the cerebellum and cognitive dysfunction in the spinocerebellar disorders deserves further research.

Exploring the Acoustic Perceptual Relationship of Speech in Parkinson's Disease

Abstract: Purpose Auditory perceptual judgments are commonly used to diagnose dysarthria and assess treatment progress. The purpose of the study was to examine the acoustic underpinnings of perceptual speech abnormalities in individuals with Parkinson's disease (PD). Method Auditory perceptual judgments were obtained from sentences produced by 13 speakers with PD and five healthy older adults. Twenty young listeners rated overall ease of understanding, articulatory precision, voice quality, and prosodic adequacy on a visual analog scale. Acoustic measures associated with the speech subsystems of articulation, phonation, and prosody were obtained, including second formant transitions, articulation rate, cepstral and spectral measures of voice, and pitch variations. Regression analyses were performed to assess the relationships between perceptual judgments and acoustic variables. Results Perceptual impressions of Parkinsonian speech were related to combinations of several acoustic variables. Approximately 36%-49% of the variance in the perceptual ratings were explained by the acoustic measures indicating a modest acoustic perceptual relationship. Conclusions The relationships between perceptual ratings and acoustic signals in Parkinsonian speech are multifactorial and involve a variety of acoustic features simultaneously. The modest acoustic perceptual relationships, however, suggest that future work is needed to further examine the acoustic bases of perceptual judgments in dysarthria.

Clinical Differences Between Stroke and Stroke Mimics in Code Stroke Patients

Abstract: Background The code stroke system is designed to identify stroke patients who may benefit from reperfusion therapy. It is essential for emergency physicians to rapidly distinguish true strokes from stroke mimics to activate code stroke. This study aimed to investigate the clinical and neurological characteristics that can be used to differentiate between stroke and stroke mimics in the emergency department (ED). Methods We conducted a retrospective observational study of code stroke patients in the ED from January to December 2019. The baseline characteristics and the clinical and neurological features of stroke mimics were compared with those of strokes. Results A total of 409 code stroke patients presented to the ED, and 125 (31%) were diagnosed with stroke mimics. The common stroke mimics were seizures (21.7%), drug toxicity (12.0%), metabolic disorders (11.2%), brain tumors (8.8%), and peripheral vertigo (7.2%). The independent predictors of stroke mimics were psychiatric disorders, dizziness, altered mental status, and seizure-like movements, while current smoking, elevated systolic blood pressure, atrial fibrillation on the initial electrocardiogram, hemiparesis as a symptom, and facial palsy as a sign suggested a stroke. In addition, the likelihood of a stroke in code stroke patients tended to increase as the number of accompanying deficits increased from the following set of seven focal neurological deficits: hemiparesis (or upper limb monoparesis), unilateral limb sensory change, facial palsy, dysarthria, aphasia (or neglect), visual field defect, and oculomotor disorder (P < 0.001). Conclusion Some clinical and neurological characteristics have been identified to help differentiate stroke mimics from true stroke. In particular, the likelihood of stroke tended to increase as the number of accompanying focal neurological deficits increased.