11/33. stuttering acquired from subcortical pathologies and its alleviation from thalamic perturbation.Acquired stuttering subsequent to subcortical pathology of mesothalamus was observed in four neurosurgical subjects. The patients suffered from chronic pain, seizures, and somatosensory disorders. They also exhibited unpredictable and uncontrollable speech, spasmodic blocks which were devoid of accessory features, and adaptation effect. Therapeutic mesothalamic stimulation, used as a treatment of last resort to relieve the pain and associated symptoms, also had an ameliorating effect on the stuttering. Spontaneously occurring focal abnormal EEG discharges were anatomically delineated and used as a guide for therapeutic stimulation electrode placement. Attentuation of the abnormal discharges was followed by alleviation of symptoms. This investigation examines the clinical characteristics of stuttering in four neurosurgical patients and suggests an electropathologic basis for their mesothalamic-generated speech dysfluencies. The cooccurrence of pain, seizures, somatosensory disorders, and stuttering, and their concurrent amelioration, suggests that both chronic pain and stuttering may be implicated by similar or related reticular electropathologic generators, couched in overlapping reticular networks extending from the brain stem to the thalamus, and that the acquired stuttering may be recruited as one component of a larger syndrome complex.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
12/33. Global motion mechanisms compensate local motion deficits in a patient with a bilateral occipital lobe lesion.Successive stages of cortical processing encode increasingly more complex types of information. In the visual motion system this increasing complexity, complemented by an increase in spatial summation, has proven effective in characterizing the mechanisms mediating visual perception. Here we report psychophysical results from a motion-impaired stroke patient, WB, whose pattern of deficits over time reveals a systematic shift in spatial scale for processing speed. We show that following loss in sensitivity to low-level motion direction WB's representation of speed shifts to larger spatial scales, consistent with recruitment of intact high-level mechanisms. With the recovery of low-level motion processing WB's representation of speed shifts back to small spatial scales. These results support the recruitment of high-level visual mechanisms in cases where lower-level function is impaired and suggest that, as an experimental paradigm, spatial summation may provide an important avenue for investigating functional recovery in patients following damage to visually responsive cortex.- - - - - - - - - - ranking = 0.051275870134771keywords = perception (Clic here for more details about this article) |
13/33. tongue dyskinesia as an early manifestation of Wilson disease.A 15-year-old boy was diagnosed as having Wilson disease. He perceived involuntary tongue movement and speech disorder since March 1990. The tongue movements presented in the resting state and during action. It contracted transversely and bilaterally with an irregular frequency about 1 Hz. As a result, the sides of the tongue moved to form a narrow central groove. This was quite different from the tongue protrusion of tardive dyskinesia. His speech had imprecise consonants, monopitch, low pitch, low volume, harsh voice, and hyponasality. These suggested that tongue dyskinesia could be an early sign of Wilson disease and was not the main cause of his dysarthria.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
14/33. Angelman's (happy puppet) syndrome: clinical, CT scan and serial electroencephalographic study.Of four patients having Angelman's syndrome admitted to a state mental facility who were clinically and electroencephalographically evaluated, 2 patients had CT scan studies of the brain. The most impressive and striking features that help in the diagnosis are the mental and physical retardation, nondevelopment of speech despite adequate visual and auditory function, various types of seizures, and episodic uncontrollable laughter. The CT scans of the brain did not offer any clue as to the pathogenesis. The EEGs appeared to fall into two groups: in one an arrest of electrical maturation occurred between ages 1 and 3 and in the other a slow but progressive maturation was evident.- - - - - - - - - - ranking = 0.5keywords = speech (Clic here for more details about this article) |
15/33. "Forme fruste" of rett syndrome--a case report.We report on a 17-year-old girl considered to represent a "forme fruste" of Rett syndrome. The history showed normal psychomotor development until age 20 months, when the girl successively lost acquired speech and developed autistic traits, moderate dementia, partial apraxia and microcephaly. However, she never stopped using her hands purposefully, nor did she develop the hand stereotypies characteristic of rett syndrome. From age 4 years she successively became more communicable and regained some of the previous abilities including some speech. At 17 she showed most of the abnormalities characteristic of adolescent girls with rett syndrome but was still only moderately retarded, with remarkably preserved motor functions. She had a peculiar apraxia. She seemed to lack "the key" to using her hands, while retaining a pincer grasp and some manipulative skills in her fingers. - It is suggested that the phenotype of rett syndrome can vary considerably and that "formes frustes" may not be an exceptional rarity among mentally retarded girls.- - - - - - - - - - ranking = 1keywords = speech (Clic here for more details about this article) |
16/33. A fatal encephalopathy in chronic haemodialysis patients.A distinct neurological syndrome in twelve chronic haemodialysis patients is described. This syndrome is currently the leading cause of death in one Denver dialysis unit. The hallmarks of this syndrome are progressive speech difficulties, mental changes, and a markedly abnormal electroencephalogram which may be present months before the clinical signs appear. Additional clinical features including seizures, myoclonus, asterixis, apraxia, focal neurological signs, and psychiatric symptoms may also be observed. Neuropathological changes are slight and non-specific. The aetiology of this syndrome is unknown but the clinical and pathological features suggest a toxic/metabolic disorder. To date, this disorder has been refractory to several therapeutic measures.- - - - - - - - - - ranking = 0.5keywords = speech (Clic here for more details about this article) |
17/33. language after bilateral cerebral infarctions: role of the minor hemisphere in speech.language was studied in four patients with bilateral cerebral infarctions. Bilateral destruction of the third frontal gyri did not necessarily produce the severely limited language output characteristic of global or severe Broca aphasia; for Broca aphasia to occur, there must be extensive frontoparietal damage in the dominant cerebral hemisphere. Thus, the marked recovery of language after lesions limited to the dominant third frontal gyrus is mediated by adjacent areas of the dominant hemisphere, and not by the nondominant third frontal gyrus. The nondominant hemisphere nevertheless has a limited capacity to produce oral speech after extensive damage to the dominant hemisphere and may play an appreciable, although still subsidiary, role in normal articulation. The central gyri and rolandic operculum may be more essential than the third frontal gyri for well-articulated speech.- - - - - - - - - - ranking = 3keywords = speech (Clic here for more details about this article) |
18/33. Choreic movements induced by the use of methadone.A 25-year-old man received methadone hydrochloride maintenance therapy for heroin addiction. Choreic movements involving the upper limbs, torso, and speech mechanisms developed. Discontinuation of methadone resulted in complete alleviation of the abnormal movements with no recurrence during the subsequent eight months. To our knowledge, this is the first recorded instance of a movement disorder induced by an opiate. The mechanisms by which drugs may after neurotransmitter relationships in the brain and produce symptoms of this type are discussed.- - - - - - - - - - ranking = 0.5keywords = speech (Clic here for more details about this article) |
19/33. dialysis encephalopathy: a review.dialysis encephalopathy (DE) is a distinct neuropsychiatric syndrome typically occurring in patients undergoing longterm hemodialysis. It is characterized by electroencephalographic abnormalities in association with disturbances of speech, cognition, movement, affect, or behavior. Previously thought to be relentlessly progressive, recent evidence linking the illness to aluminum overload has led to advances in prevention and treatment. early diagnosis aids in the reversal or amelioration of the syndrome and can be of immense value to the patient, the family and involved health personnel. The general features of the syndrome, etiologic considerations, differential diagnosis and treatment are discussed. Three case studies are included to illustrate salient features of the syndrome.- - - - - - - - - - ranking = 0.5keywords = speech (Clic here for more details about this article) |
20/33. Reversibility of chronic neurologic deficits. Some effects of electrical stimulation of the thalamus and internal capsule in man.Stimulation of the thalamus and internal capsule with Medtronic deep brain stimulation electrodes produced improvement in pain, hemiparesis, dystonia, torticollis, tremor. speech impairment and epilepsy. Stimulation at voltages above or below clinically effective levels (e.g., 6 V, 0.3 ms, 74 Hz) resulted in a loss of clinical efficacy. Somatosensory evoked responses (short and long latency) and depth electrode recordings were helpful in localisation and 'biocalibration' of electrical stimulation.- - - - - - - - - - ranking = 0.5keywords = speech (Clic here for more details about this article) |
| <- Previous || Next -> |