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

Dysprosody is typically associated with the dysarthrias following acquired neurogenic disturbance but it has also been associated with impairment to the cortex of the right cerebral hemisphere (Behrens, 1985). Currently there is little agreement in the clinical literature as to the locus or nature of processes involved in production and reception of prosody. This paper investigates the usefulness of two psycholinguistic models of prosody--involving "abstract" and "concrete" processes (Ladd & Cutler, 1983)--in accounting for dysprosody following motor pathway as well as cortical lesions. Four groups of 10 adult patients each participated in the study; the first group had sustained a right cerebral hemisphere cortical stroke, the second group had hypokinetic dysarthria, the third group had ataxic dysarthria, and the fourth group was normal controls. Acoustic analysis using the Kay VisiPitch/PC was conducted on pairs of matched noun phrase and noun compounds (e.g., greenhouse, green house), interrogative and declarative versions of sentences, and sentences spoken in each of four different emotional tones. Right cerebral hemisphere damaged subjects produced shorter durations than the other groups for each stimulus class. However, all of the subjects were able to use duration to signal temporal information for the lexical distinction between noun compounds and noun phrases. The results are consistent with a model of prosodic control which involves both cortical as well as physiological control processes. Current treatment for dysprosody is discussed in light of this new emphasis on cognitive control processes.
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PMID:Dysprosody following acquired neurogenic impairment. 835 29

Ten patients with clinically probable brainstem stroke presenting primarily as acute dysphagia but without visible brainstem abnormality by MRI are described. The patients were evaluated with neurologic examinations, cinepharyngoesophagography, and brain MRI studies. Each patient solely or predominately experienced sudden pharyngeal dysphagia, and additional symptoms or signs other than dysphonia or dysarthria were scarce. Small vessel disease or cardiac embolism were the apparent causes of what appear to have been very discrete brainstem strokes in these patients. Acute pharyngeal dysphagia can be the sole or primary manifestation of brainstem stroke. A negative MRI study should not preclude consideration of this diagnosis, if brainstem stroke is otherwise clinically probable.
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PMID:Clinically probable brainstem stroke presenting primarily as dysphagia and nonvisualized by MRI. 835 44

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.
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PMID:No place for motor speech acts in the assessment of dysphagia? Intelligibility and swallowing difficulties in stroke and Parkinson's disease patients. 840 Apr 91

We studied 34 consecutive patients with non-mass-producing cerebellar infarcts using a standard protocol of investigations including magnetic resonance imaging (MRI). We analyzed the topography of infarcts to determine the involved arterial territories and we correlated the findings with neurological dysfunction and potential causes of stroke. Sixteen patients had an infarct in the territory of the posterior inferior cerebellar artery (PICA); 2, in the territory of the anterior inferior cerebellar artery (AICA); 13, in the territory of the superior cerebellar artery (SCA); and 8 had junctional infarcts between the territories of the medial and lateral branches of the PICA or PICA/SCA territories. PICA or medial PICA territory infarcts were manifested by acute vertigo and truncal ataxia, while the patients with lateral PICA territory infarcts presented with unsteadiness, limb ataxia and dysmetria without dysarthria. Patients with infarcts in the AICA territory were characterized by limb and trunk ataxia associated with signs of lateropontine involvement. Patients with SCA territory infarcts presented with dysarthria, unsteadiness and/or vertigo, limb ataxia, and dysmetria. Cardiac embolism was the main cause of large infarcts in the territories of the PICA (8/16) or SCA (4/7). Multiple small infarcts were associated with vertebrobasilar atherosclerosis (8/12). These clinical-MRI correlations allow better definition of the topographic and etiological spectrum of cerebellar infarction, which was previously based on pathological studies in subjects with severe infarction.
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PMID:The clinical and topographic spectrum of cerebellar infarcts: a clinical-magnetic resonance imaging correlation study. 849 23

Foix-Chavany-Marie Syndrome or anterior opercular syndrome constitutes the cortical form of pseudobulbar palsy. Its most common etiology is stroke in the region of either operculum. Clinically it can be characterized by severe dysarthria and facio-pharyngo-glosso-masticatory dysplasia with automatic-voluntary dissociation. An inversion of this classical dissociation can be seen in patients with emotional paralysis in the face, in whom asymmetry of emotional expression but conservation of voluntary movement can be seen. The lesional topography of this inverse dissociation corresponds to the supplementary motor area. both processes support the existence of an anatomical base which is different for emotional movements and voluntary types. We describe the clinical case of a 65 year old woman with a history of breast cancer who presented a subacute and progressive clinical picture of dysphagia and severe dysarthria. Upon neurological examination slight velo-palato-pharyngea was noticed; most relevant was paralysis of the facial muscles for either emotional or automatic movements while voluntary innervation was maintained. Neuroradiological studies show the presence of brain metastasis located in both Roland opercula. Although the neuroanatomic bases for automatic-voluntary dissociation remain unclear, our case lends weight to the evidence that impulses for voluntary and emotional movements originate in different cortical areas or else take a different route through the brain. We have been unable to find any cases of biopercular lesion with inverse dissociation described in the literature we reviewed.
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PMID:[Biopercular lesion with inverse dissociation]. 855 92

We studied 36 patients with MRI-proven isolated acute pontine infarct. Corresponding to the constant territories of intrinsic pontine vessels, infarcts followed a predictable distribution, enabling us to delineate three main syndromes. Twenty-one patients had a ventral pontine infarct. Motor involvement varied from mild hemiparesis (ventrolateral pontine syndrome) to severe hemiparesis with bilateral ataxia and dysarthria (ventromedial pontine syndrome). In addition, three-fourths of the patients had clinical evidence for usually mild tegmental dysfunction. Eleven patients had a tegmental pontine infarct, presenting tegmental signs (eye movement disorders, cranial nerve palsies, sensory disturbances), and mostly mild motor deficits (tegmental pontine syndrome). Only four patients had alternating deficits, and these never corresponded to any of the so-called classic pontine syndromes. Infarcts in the medial and the extreme lateral tegmental territory were never observed in isolation, being always associated with cerebellar or larger (and multiple) infarctions in the posterior circulation. Four patients with a bilateral ventrotegmental pontine infarct presented with acute pseudobulbar palsy, bilateral motor deficits, and tegmental signs. The results of etiologic work-up emphasize the concept of basilar artery branch disease, which was the most common presumed cause of stroke (16/36, 44%). Basilar artery branch disease was particularly associated with large ventral infarcts, severe clinical symptomatology, progressive or fluctuating course, and local recurrence. Presumed small-artery disease (9/36, 25%) was usually associated with small ventral or tegmental infarcts and rapidly improving lacunar syndromes. Large-artery stenosis (8/36, 22%) and cardioembolism (1/36, 3%) were less common than in series of posterior circulation infarcts that include simultaneous pontine and extrapontine lesions. Recovery was good in two-thirds of the patients, the worse outcome being associated with large ventral infarcts.
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PMID:Isolated infarcts of the pons. 855 68

Statistically identified information on the relationships between the sites of lesions in intracerebral hemorrhage (ICH), risk factors such as a smoking or drinking habit, anamnesis, and biochemical data through blood tests will extend assistance to neuromedical clinicians on their daily clinical duties. It will provide them with a useful guide to determine the method of treatment. Also, it will be a basic research material for their clinical studies on diagnosis, progress, or prognosis in ICH. In order to obtain such statistics with the help of the computer, we need to have a computationally effective image database system. As is generally known, medical image data especially requires a great amount of storage; high-speed processing techniques are therefore also needed to deal with such data effectively. In addition, it is desired that we have outputs from the analysis edited with well-visualized effect, using 3D computer graphics, etc. These are why most existing image processing systems have been designed to work on comparatively large-scale computers. So far as we know, it is hard to find a practical and inexpensive personal computer-based application system for visualized statistical analysis of lesional images in ICH. We have developed a desk top computer-based program for statistical analysis of lesional image data of ICH. With this system, we can organize a medical image database that consists of the personal data of patients with ICH (sex, age, occupation, diagnosis, symptoms, part of physical disorder, etc.), risk factors, anamnesis (cerebral apoplexy, hypertension, hypotension, corpulence, diabetes, hyperlipidemia, atrial fibrillation, valvular endocarditis, etc.), biochemical data of blood, and lesional image data from CT or MRI. This system consists of the following components: 1) database management, 2) information retrieval (IR), 3) lesional image processing, 4) statistical analysis, and 5) prognostic prediction. The images are drawn manually on prescribed data sheets by tracing CT or MRI films and are read through the image scanner; then the compressed data of the digitized images is recorded in the database. Each recorded image data consists of the following two components: the frame image that corresponds to the contour of tissues of interest on the corresponding sliced section, and the actual image that corresponds to the lesion itself. In our system, these two images are separately stored and managed so that we can effectively perform subsequent image analysis. Other variables in the database (risk factors, anamnesis, etc.) are mainly used as search keys for making the aggregate of image data by the IR subsystem. In any aggregate, its elements, namely image data, have common medical background descriptions with the search keys. These aggregates can be used as input for the lesional image processing subsystem. With this subsystem, we can obtain the accumulated distribution of frequencies within a specified range of any sliced section, display planar color maps and profiles associated with the distribution, reconstruct it in 3D form, perform transformations of 3D images (zooming, enhancement, rotation, etc.), and test the significant difference of frequencies between any two different sites. We have been making practical use of this system to find the neurological relationship between the symptom (dysarthria, and paralysis of upper/lower limbs) and the site of lesion with cerebral infarction in pons. This study is quite important since the distributions of pyramidal tract related to the above symptom in pons are not well-known compared to those in cerebral cortex, internal capsule, or cerebral peduncle. With our system, we have obtained several findings expected to be helpful for this study. However, since this study is still in the initial phases, we will only present the outcome as a working example of our system. Our system was originally developed for analyzing lesional images with ICH. However, it could
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PMID:A desk top computer program for visualized statistical analysis of lesional images in intracerebral hemorrhage. 859 83

The purpose of the present study was to survey and compare the knowledge and attitudes of final year occupational therapy, physiotherapy and speech-language therapy students, concerning the role of the speech-language therapist as a member of the stroke rehabilitation team in the hospital setting. In order to achieve this aim, a questionnaire was administered to final year students in these three disciplines, and included questions on most areas of stroke rehabilitation with which the speech-language therapist might be involved, as well as the concepts of rehabilitation and teamwork in relation to stroke rehabilitation. Results suggested a fairly good understanding of the concepts of rehabilitation and teamwork. Students appeared to have a greater understanding of those disorders following a stroke, with which the speech-language therapist is commonly involved, such as Aphasia, Dysarthria, Verbal Apraxia and Dysphagia. However, students appeared to show less understanding of those disorders post-stroke, for which the speech-language therapist's role is less well defined, such as Agraphia, Alexia and Amnesia. In addition, a high percentage of role duplication/overlapping in several aspects of stroke rehabilitation, such as family and social support, was found. Several implications for facilitating communication, collaboration and understanding between paramedical professions, as well as for further research are also provided.
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PMID:The knowledge and attitudes of occupational therapy, physiotherapy and speech-language therapy students, regarding the speech-language therapist's role in the hospital stroke rehabilitation team. 860 43

Patients presenting with heat stroke may develop an acute pancerebellar syndrome. A patient presenting with an isolated cerebellar dysarthria after a heat stroke is reported. The dysarthria lasted two weeks. An isolated cerebellar dysarthria has been previously described in lesions of the paravermal zone of the rostral cerebellum. It is suggested that this region of the cerebellum is particularly vulnerable to fever.
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PMID:Isolated cerebellar dysarthria associated with a heat stroke. 868 82

The dysarthrias form a group of diverse, chronic motor speech disorders. The disorders of Parkinson's disease, stroke, traumatic brain injury, amyotrophic lateral sclerosis, and cerebral palsy are reviewed because they represent important clinical diagnoses in which dysarthria is a frequent and debilitating symptom. The roles played by speech-language pathologists include participation in differential diagnosis, provision of speech treatment, staging of treatment, and timely education so that clients and families can make informed decisions about communication alternatives. Both scientific and clinical evidence is presented that suggests that individuals with dysarthria benefit from the services of speech-language pathologists. Group-treatment studies, single-subject studies, and case reports illustrate the effectiveness of various types of speech treatment. Research into the effectiveness of augmentative and alternative communication systems for individuals with cerebral palsy is also presented.
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PMID:Treatment efficacy: dysarthria. 889 66


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