Cases reported "Speech Disorders"

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1/37. When is a /k/ not a [k]? EPG as a diagnostic and therapeutic tool for abnormal velar stops.

    This case study describes a boy who at the age of eight years did not have consistent or contrastive use of velar stops in his spontaneous speech. The use of electropalatography (EPG) revealed abnormal tongue-palate contact for both velar and alveolar stops, all of which were perceived as normal, there was excess contact in the palatal region for all alveolars and velars in a word initial position and double velar/palatal articulation for velars in a word final position. Therapy using EPG for visual feedback was highly successful and post therapy data showed normal-looking EPG patterns for alveolar and velar stops. The assessment, diagnostic and therapeutic implications are discussed.
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ranking = 1
keywords = visual
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2/37. Effects of facial paralysis and audiovisual information on stop place identification.

    This study investigated how listeners' perceptions of bilabial and lingua-alveolar voiced stops in auditory (A) and audiovisual (AV) presentation modes were influenced by articulatory function in a girl with bilateral facial paralysis (BFP) and a girl with normal facial movement (NFM). The fuzzy logic Model of perception (FLMP) was used to make predictions about listeners' identifications of stop place based on assumptions about the nature (clear, ambiguous, or conflicting) of the A or AV cues produced by each child during /b/ and /d/ CV syllables. As predicted, (a) listeners' identification scores for NFM were very high and reliable, regardless of presentation mode or stop place, (b) listeners' identification scores for BFP were high for lingua-alveolar place, regardless of presentation mode, but more variable and less reliable than for NFM; significantly lower (overall at a chance level) for bilabial place in the A mode; and lowest for bilabial place in the AV mode. Conflicting visual cues for stop place for BFP's productions of /bV/ syllables influenced listeners' perceptions, resulting in most of her bilabial syllables being misidentified in the AV mode. F2 locus equations for each child's /bV/ and /dV/ syllables showed patterns similar to those reported by previous investigators, but with less differentiation between stop place for BFP than NFM. These acoustic results corresponded to the perceptual results obtained. (That is, when presented with only auditory information, on average, listeners perceived BFP's target /b/ syllables to be near the boundary between /b/ and /d/.)
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ranking = 6
keywords = visual
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3/37. Foreign Accent syndrome following a catastrophic second injury: MRI correlates, linguistic and voice pattern analyses.

    A case study of Foreign Accent syndrome (FAS) is presented with discussion of anatomical localization of injury and comparisons of pre- and postinjury linguistic, phonetic, and acoustic speech characteristics. Because the patient's injury and symptoms were unrelated to previously injured left frontal cortex, and in light of another case history (Moonis et al., 1996), we suggest that FAS has a primary subcortical involvement. We also show that this case is accompanied by a deficit in linguistic, but not affective, prosodic expression. We agree that the "foreign" quality of the FAS speech is a perceptual impression of the listener and not inherent in the patient's vocalization. Finally, we suggest a battery of tests for future FAS cases to further our study and understanding of the syndrome.
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ranking = 18.271844583275
keywords = cortex
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4/37. multiple sclerosis and oral care.

    multiple sclerosis is a complex neurological condition affecting sensory and motor nerve transmission. Its progression and symptoms are unpredictable and vary from person to person as well as over time. Common early symptoms include visual disturbances, facial pain or trigeminal neuralgia and paraesthesia or numbness of feet, legs, hands and arms. These, plus symptoms of spasticity, spasms, tremor, fatigue, depression and progressive disability, impact on the individual's ability to maintain oral health, cope with dental treatment and access dental services. Also, many of the medications used in the symptomatic management of the condition have the potential to cause dry mouth and associated oral disease. There is no cure for multiple sclerosis, and treatment focuses on prevention of disability and maintenance of quality of life. Increasingly a multi-disciplinary team approach is used where the individual, if appropriate his/her carer, and the specialist nurse are key figures. The dental team plays an essential role in ensuring that oral health impacts positively on general health.
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ranking = 1
keywords = visual
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5/37. Early ictal speech and motor inhibition in fronto-mesial epileptic seizures: a polygraphic study in one patient.

    OBJECTIVE: To investigate ictal motor inhibition occurring during seizures in a patient with a tumor located in the left fronto-mesial pre-central cortex. methods: Awake and sleep video-polygraphic monitoring, recording scalp EEG and EMG activities from several cranial, trunk and limbs muscles, was performed in a patient with drug-resistant recurrent focal motor seizures before surgical treatment. speech/motor tasks were repeatedly administered to the patient during the recording sessions in order to evaluate the occurrence of early ictal motor inhibition. RESULTS: Thirty-four seizures were recorded during wakefulness showing a stereotyped pattern of inhibition of speech and voluntary movements followed by sequential activation of upper limb-trunk-lower limb muscles contralateral to the tumor. Polygraphic recordings showed that: (1) initial speech and motor arrest were associated with the EMG evidence of progressive muscle tone suppression in cranial and right distal upper limb muscles; (2) tonic contraction of right deltoid, biceps brachii, intercostalis and paraspinalis muscles appeared after motor inhibition; (3) tonic-clonic activity in the right tibialis anterior muscle occurred at the end of seizures. Eleven subclinical seizures were recorded during sleep showing mild focal tonic EMG activity in right side trunk muscles. CONCLUSIONS: Our findings evidenced early and somatotopically organized inhibition of voluntary movement at the beginning of epileptic seizures with fronto-mesial onset. The demonstration that speech and motor arrest were associated with progressive EMG suppression in cranial and limb muscles supports the hypothesis of motor inhibitory seizures originating in the mesial aspect of pre-motor frontal cortex.
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ranking = 36.543689166551
keywords = cortex
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6/37. Slowed lexical access in nonfluent aphasia: a case study.

    A list priming paradigm (LPP) was used to examine the hypothesis that nonfluent aphasics are literally slowed down in automatic access to lexical information. In this paradigm, words are presented visually, and the subject's task is to make a lexical decision on each word as quickly as possible after its presentation. As soon as a lexical decision is made on one word, that word is removed and, after a predetermined interword interval, the next word is presented. In this way, a continuous "list" effect is obtained. Prior studies with both college-age and elderly subjects using the LPP have shown that, independently of age, on the LPP, priming obtains at interword delays of 500 to 800 msec, but not at either shorter or longer interword delays. In the study reported here, the LPP was used to examine delays at which priming obtained for LD, a nonfluent aphasic with a lesion primarily in the left frontal region. Examining interword delays ranging from 500 to 1800 msec, the subject showed priming only at a delay of 1500 msec, a considerably longer delay than that at which neurologically intact subjects have shown priming. Based on these results, it is argued that while automatic access is retained, that access is much slower in a nonfluent aphasic than in neurologically intact elderly subjects. These results are discussed in terms of how slowed lexical access might impact on discourse comprehension.
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ranking = 1
keywords = visual
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7/37. Functional MRI study of verbal fluency in a patient with subcortical laminar heterotopia.

    RATIONALE: Double cortex syndrome is a malformation in which there is a band of subcortical heterotopic grey matter separated from the cortex by white matter. The functional activity of the heterotopic neurons is unclear. PATIENT: A 13-year-old female was evaluated for seizures. The EEG showed bifrontal spike wave disturbance. Band heterotopia, in association with mild reduction of sulcation of the cerebral hemispheres, was found on MRI. Psychological assessment indicated the presence of variable cognitive abilities, with verbal IQ [82] generally better than nonverbal IQ [59], and specific difficulties in language comprehension and mathematics. METHOD: Functional MRI was used to localize the areas of language and motor activation. The language activation paradigm was a visual verb generation task with a visual fixation baseline. The motor paradigm consisted of alternating blocks of sequential finger tapping and rest. Coronal functional and anatomical images were obtained. RESULTS: The motor paradigm produced activation of the primary motor cortex, the band heterotopia and the supplementary motor cortex. The language paradigm produced activation of the left inferior frontal gyrus and left supplementary motor area, but not of the band heterotopia. CONCLUSIONS: The activation of heterotopic grey matter during a motor task demonstrates a hemodynamic association with motor activity and suggests that this tissue may be functional. Such association was not seen with the language task. We speculate that later maturing functions such as language are restricted in their development to the normal situated superficial cortex in our patient.
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ranking = 93.359222916377
keywords = cortex, visual
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8/37. Magnetoencephalographic analysis of rolandic discharges in a patient with rolandic epilepsy associated with oromotor deficits.

    The purpose of this study was to clarify the neurophysiologic basis of oromotor deficits in a patient with atypical rolandic epilepsy. We investigated magnetoencephalographic analysis of rolandic discharges with right predominance before and during clonazepam therapy. Before clonazepam administration, current sources of rolandic discharges were broadly distributed in the secondary sensory cortex, superior temporal gyrus, and parietal association area in addition to hand and orofacial division of the primary somatosensory cortex. During clonazepam therapy, oromotor deficits were improved, along with a decrease in rolandic discharge, and current sources of residual right-sided rolandic discharges were shifted to the right superior parietal lobule. Taking the clinical course and magnetoencephalographic findings together, the distributed rolandic discharge focus might be closely related to oromotor deficits, and clonazepam was effective for the disorder.
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ranking = 36.543689166551
keywords = cortex
(Clic here for more details about this article)

9/37. Effects of synthetic speech output in the learning of graphic symbols of varied iconicity.

    PURPOSE: To examine the effects of additional auditory feedback from synthetic speech on the learning of high translucent symbols versus low translucent symbols. METHOD: Two adults with little or no functional speech and severe intellectual disabilities served as participants. A single-subject ABACA/ACABA design was used to study the relative effects of two treatments: symbol training in the presence and absence of synthetic speech output. RESULTS: The results clearly indicated that the two treatments, rather than extraneous variables were responsible for gains in the symbol learning. Both participants learned either more low translucent symbols or reached their maximum learning of low translucent symbols in the speech output condition. CONCLUSIONS: The results of this preliminary study replicate and extend the iconicity hypothesis to a new set of learning conditions involving speech output, and suggest that feedback from speech output may assist adults with profound intellectual disabilities in coding particularly those symbols whose association with their referent cannot be coded via their visual resemblance with the referent.
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ranking = 1
keywords = visual
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10/37. speech arrest with stimulation may not reliably predict language deficit after epilepsy surgery.

    The authors present a patient in whom electrical cortical stimulation of the posterior temporal cortex induced speech arrest, comprehension deficits, and other language-related impairments. This area was ultimately resected because of persistence of a severe seizure disorder. No postoperative aphasia was observed despite the cortical stimulation results, and the patient is since seizure free. These findings question the well-established principle that corticography directly reflects local cortical functions in all patients.
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ranking = 18.271844583275
keywords = cortex
(Clic here for more details about this article)
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