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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The paper gives a short survey of the phylogenetic development of the laryngeal and supralaryngeal apparatus from amphibians to man. The increasing differentiation of vocal behaviour, paralleling the differentiation of the vocal apparatus, is outlined and special reference is made to the non-verbal component in human language. It is stressed that animal vocal repertoires can be extremely rich, but in contrast to human verbal behaviour they are generated almost exclusively by laryngeal modulations and only to a minimal degree by supralaryngeal activity (i.e. articulation). A phylogenetic development can also be seen in the cerebral organization of vocal behaviour. In amphibians, reptiles and lower mammals, the dorsal midbrain-pons transitional zone seems to be the only area responsible for the production of vocal utterances. This area probably serves in integrating vocal fold movements, expiration, intra- and extra-oral muscle activity into species-specific vocal patterns; its destruction results in mutism. In higher mammals, including man, this area does not lose its original function but is brought under the control of the cortex around the anterior sulcus cinguli (supplementary motor area and anterior cingulate gyrus). The latter seems to play an essential role in the initiation of vocal utterances in situations which do not have a rigid stimulus-response characteristic, i.e. in voluntary vocal behaviour. The highest level of voice production, finally is represented by the cortical face area, the destruction of which is without consequence to the innate vocal behaviour of animals but produces dysarthria in man. This area (together with its associated structures, such as the cortex-pontine nuclei-cerebellum-thalamus-cortex circuit) seems to be essential for the production of verbal or, more generally, learned vocal behaviour.
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PMID:[On the evolution of voice (author's transl)]. 99 89

The authors report three children who suffered transient loss of speech during six to eight weeks following removal of a large midline cerebellar tumour. None manifested speech difficulties immediately after surgery, but all developed mutism within 24 to 48 hours. The speech of all children slowly but completely recovered, after a period of severe dysarthria. The re-organization of speech functions is discussed in relation to the functioning of musculature.
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PMID:Transient loss of speech followed by dysarthria after removal of posterior fossa tumour. 145 41

Serial brain CT and 123I-IMP SPECT were examined in a case with Creutzfeldt-Jakob disease (CJD). A 61-year-old woman had the onset of progressive dementia and gait disturbance in December 1988. Then, she developed left hemiparesis and dysarthria, and rapidly fell into akinetic mutism within about 2 months. Brain CT, MRI, and CSF findings showed no definite abnormalities. In February 1989, myoclonic movements appeared in several parts of the body and EEG revealed periodic synchronous discharges. Myoclonus was observed most frequently from March to May 1989, and then reduced gradually. She died in June 1990, and the total clinical course was 19 months. Brain atrophy on CT started from about 4 months after the onset, and progressed subacutely. At the end stage of the disease, diffuse brain atrophy including the cerebellum and the brain stem on CT was observed. SPECT revealed decreased perfusion in the cerebral cortex from 5 months after the onset to the end stage, but; perfusion in the cerebellum and the basal ganglia was relatively kept even at the end stage of the disease. The results suggest that SPECT is a useful examination for presumption of the pathological processes in CJD.
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PMID:[Serial brain CT and 123I-IMP SPECT in a case with Creutzfeldt-Jakob disease]. 155 58

We present a case of malignant neuroleptic syndrome in a 55 years old male diagnosed 3 years ago of alcoholic paranoid psychosis who was chronically treated with haloperidol, clothiapine, and phenobarbital. Twenty one days after neuroleptic drug withdrawal the patient was admitted to the recovery room because of hyperthermia (40.2 degrees C), left basal pneumonia, acute respiratory insufficiency, extrapyramidal rigidity, mutism, dysarthria, deep coma, hypotension, and tachycardia. Two days after he presented massive rhabdomyolysis, atrial flutter with hemodynamic deterioration which reverted to sinus rhythm and acute anterolateral and inferior myocardial infarction documented by enzyme rise and electrocardiographic alterations. Rhabdomyolysis and myocardial infarction were the precipitating factors of the renal insufficiency. A malignant neuroleptic syndrome was suspected and intravenous treatment with dantrolene sodium 1.5 mg/kg every 24 hours was initiated. Bromocriptine was not administered. The patient died 14 days after in the course of a sepsis and cardiogenic shock.
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PMID:[Malignant neuroleptic syndrome associated with myocardial infarction, acute renal insufficiency and rhabdomyolysis]. 168 57

Acute aphasia is in most cases due to cerebrovascular disease. Its occurrence is a strong indication of a lesion in the language-dominant hemisphere, i.e. usually the left. Aphasia has to be differentiated from confusional states, mutism and dysarthria. We present the different aphasic syndromes, the clinical evaluation of patients with aphasia, the differential diagnosis and etiological considerations. Finally, therapeutic approaches to aphasia treatment are pointed out.
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PMID:[Acute aphasia]. 170 Apr 60

A case of mutism after removal of a vermian medulloblastoma from a 4-year-old girl is reported. Postoperatively, the patient was mute without disturbance of consciousness, language comprehension, or lower cranial nerve function. Computed tomography scans demonstrated no abnormal findings except for the surgical lesion in the posterior fossa. The mutism lasted for 78 days, followed by a period of dysarthria, but she gradually became fluent. The mechanism of "cerebellar mutism" is briefly discussed.
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PMID:Mutism after removal of a vermian medulloblastoma: cerebellar mutism. 194 32

A large midline posterior fossa medulluloblastoma and a cerebellar arteriovenous malformation with associated clot were moved with postoperative mutism. Mutism was immediate and resolved into an ataxic dysarthria with residual mild dysarthria at 3 months. The literature is reviewed, and the clinicopathological and neurophysiological data of cerebellar function in speech are discussed. Acute injury to the midportion of the cerebellum with or without dentate nuclear involvement can cause a spectrum of speech disturbances. The more widespread the injury to the midportion of the cerebellum with dentate nuclei involvement the greater the risk of developing postoperative mutism.
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PMID:Cerebellar mutism after posterior fossa surgery. 213 6

Three patients aged 5 1/2 to 9 years old with mutism after posterior fossa surgery are presented. The entity is discussed with a review of 15 additional previously reported cases in children aged 2 to 11 years. In all 18 patients, a large midline tumor of the posterior fossa (medulloblastoma in nine cases, astrocytoma in five, and ependymoma in four), often attached to one or both lateral recesses of the fourth ventricle, was removed. Mutism developed 18 to 72 hours after the operation (mean 41.5 hours) in patients with no disturbance of consciousness and no deficits of the lower cranial nerves or of the organs of phonation. All of these children had spoken in the first hours after surgery. The disorder lasted from 3 to 16 weeks (mean 7.9 weeks). Speech was regained after a period of dysarthria in six of the 10 cases for whom this information was available. The various hypotheses advanced to explain the pathogenesis of this speech disorder are analyzed.
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PMID:Mutism after posterior fossa surgery in children. Report of three cases. 218 60

Two patients developed the locked-in state characterised by quadriplegia and mutism with an alert sensorium. Initially they had mild dysarthria and uncrossed hemisensory or hemimotor deficits involving the face and ipsilateral extremities. Both patients died. Rostral brainstem infarctions were found at autopsy in them. Acute onset of uncrossed hemisensory and hemimotor deficits with dysarthria may be caused by infarction of the pons which may predispose to locked-in state.
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PMID:Locked in state. A clinicopathological study. 239 7

Acute mutism with paralysis of the bulbar and facial muscles following discrete bilateral internal capsular infarction is a rare stroke syndrome. We describe a 62 year-old male who suddenly became unable to speak or swallow. The paucity of facial expression and inability to voluntarily move the facial, lingual and pharyngeal muscles were persistent and contrasted with a relatively mild limb paresis which recovered. High resolution CT scan revealed infarcts in the posterior limbs of both internal capsules. It is important to recognise this stroke syndrome because of the permanence of dysarthria and dysphagia associated with it.
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PMID:Persistent mutism and dysphagia of acute onset due to bilateral internal capsule infarction. 239 43


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