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

Twenty-four individuals with impaired speech (anarthria or dysarthria) were compared on tests of receptive language to a control group with normal speech. All subjects were cerebral-palsied and groups were matched on age and nonverbal ability. The speech-impaired subjects performed less well than controls on a phoneme discrimination task in which they were required to judge whether pairs of nonwords were the same or different. They were also impaired relative to controls on a receptive vocabulary test, but not in understanding of grammatical structure. One year later, phoneme discrimination skills were reassessed in this sample, using another same-different task, plus a new task in which subjects were required to judge if the name of a picture was spoken correctly or altered by one sound. Speech-impaired subjects performed as well as controls on the word judgment task, indicating that they can discriminate phoneme contrasts adequately. However, the same-different task again resulted in highly significant differences between speech-impaired and control groups. It is concluded that poor performance on the same-different task reflects weak memory for novel phonological strings, rather than impaired phoneme perception. It is proposed that retention of unfamiliar words is facilitated by overt or covert repetition, so individuals who cannot speak fluently have difficulty remembering nonwords. This explanation can account both for the poor performance of speech-impaired subjects on the same-different task, and for their selective deficit in vocabulary acquisition.
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PMID:The relationship between phoneme discrimination, speech production, and language comprehension in cerebral-palsied individuals. 235 62

We analyzed the dysarthria of four children with bilateral supranuclear facial palsy and four with bilateral peripheral facial palsy. The children with peripheral lesions had only moderate dysarthria, characterized mainly by weakened vowels and consonants and by hypernasality. In contrast, children with supranuclear lesions were anarthric at first, followed by severe dysarthria with reduced stress and many pauses. Although there was a relation between severity of dysarthria and neurologic disorders, anarthria can be seen in children with bilateral supranuclear lesions and only slight neurologic disability. Damage to cortical or brainstem control mechanisms may be responsible.
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PMID:Acquired dysarthria in childhood: an analysis of dysarthric features in relation to neurologic deficits. 380 12

An unselected series of 116 dyskinetic cerebral palsy cases born 1959-70 was delineated and subgrouped according to neurological criteria into 35 hyperkinetic (30%) and 81 dystonic (70%) cases. Of the hyperkinetics, 80% had a mild motor disability, while 90% of the dystonics had moderate or severe disability. Subordinated spastic signs were found in 9% of the hyperkinetic and in 44% of the dystonic cases. IQ was greater than 90 in 69% of the hyperkinetics and 25% of the dystonics and less than 50 in 11% and 41%, respectively. Two or more additional neurological abnormalities (spasticity, mental retardation, epilepsy, anarthria, dysarthria, hearing deficit) were detected in 46% hyperkinetic and 81% dystonic cases. A heavy multihandicap complex was present predominantly in the dystonic subgroup. The 5-19 year mortality rate was 6% and was confined to the most severely handicapped dystonic cases. The twin rate was 5%. A total of 9% had birth weights less than or equal to 1500 g, and 31% had less than or equal to 2500 g. The weight- and age-specific incidences increased rapidly with decreasing birth weights and gestational ages. The crude incidence of hyperkinetic cerebral palsy was 0.07 and dystonic cerebral palsy 0.17 per thousand live births.
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PMID:Dyskinetic cerebral palsy. I. Clinical categories, associated neurological abnormalities and incidences. 713 69

64 patient on chronic haemodialysis were investigated. The duration of the dialysis was 44 months; the mean age of patients was 41 years. In 6 patients a diagnosis of Dementia was made in addition to apraxia, dysarthria and anarthria. 5 of the patients died. All the demented patients showed an abnormal EEG and 4 had atrophy in the computertomogram. The plasma aluminium levels were significantly raised (409 microgram/l) in the demented group as compared to the non-demented dialysis patients (189 microgram/l).
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PMID:[The importance of aluminiun in dialyseencephalopathie (author's transl)]. 723 9

Mutism can be defined as "a condition in which there is no, or very little, oral-verbal expression, whereas comprehension of speech ... is normal or at least at a considerably higher level" (Lebrun, 1990). Benson (1979) enumerates five neuroanatomical correlates of mutism: (a) damage to the Broca region, (b) lesion of the supplementary motor area of the dominant hemisphere, (c) dysfunction of the mesencephalic reticular system, (d) thalamotomy, and (e) bilateral pathology of cortical and subcortical motor structures. The last item refers to syndromes of mutism resulting from central motor disorders. Depending on location and size of the lesion this pathophysiological interpretation should hold true for the fourth point as well. In mutism due to central motor disturbances lacking verbal expression represents the most severe degree of dysarthria, i.e. anarthria. The present review provides a detailed description of mutism following corticobulbar, striatal, and cerebellar dysfunctions.
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PMID:[Mutism in central motor disorders--a review of the literature]. 795 17

Language disturbances in cerebral palsy with mutism. The analysis of the afferent side of language in 18 cerebral palsy children with no oral expression shows that they form a very heterogeneous population. The semiological analysis concerning comprehension leads to their classification into four main groups akin to the classical dysphasia syndromes. Major agrammatism occurring in phonologico-syntactic dysphasia. Sensory dysphasias (or verbal deafness). Mixed (or global) dysphasias. Motor dysphasias: phonological programmation disturbances (anarthria) and motor production disturbances (dysarthria). The disclosure of these various dysphasias allows for specific rehabilitation and for education procedures suitable for each individual patient.
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PMID:[Symptomatology of language disorders in cerebral palsy with mutism]. 821 52

We describe eight patients with slowly progressive speech production deficit combining speech apraxia, dysarthria, dysprosody and orofacial apraxia, and initially no other deficit in other language and non-language neuropsychological domains. Long-term follow-up (6-10 years) in 4 cases showed an evolution to muteness, bilateral suprabulbar paresis with automatic-voluntary dissociation and frontal lobe cognitive slowing without generalised intellectual deterioration. Most disabled patients presented with an anterior opercular syndrome (Foix-Chavany-Marie syndrome), and pyramidal or extrapyramidal signs. CT and MRI findings disclosed asymmetric (left > right) progressive cortical atrophy of the frontal lobes predominating in the posterior inferior frontal region, notably the operculum. SPECT and PET revealed a decreased cerebral blood flow and metabolism, prominent in the left posterior-inferior frontal gyrus and premotor cortex, extending bilaterally in the most advanced cases. Pathological study of two cases showed non-specific neuronal loss, gliosis, and spongiosis of superficial cortical layers, mainly confined to the frontal lobes, with no significant abnormalities in the basal ganglia, thalamus, cerebellum, brain stem (except severe neuronal loss in the substantia nigra in one case), and spinal cord. We propose to call this peculiar syndrome Slowly Progressive Anarthria (SPA), based on its specific clinical presentation, and its metabolic and pathological correlates. SPA represents another clinical expression of focal cortical degeneration syndromes, that may overlap with other similar syndromes, specially primary progressive aphasia and the various frontal lobe dementias.
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PMID:Slowly progressive anarthria with late anterior opercular syndrome: a variant form of frontal cortical atrophy syndromes. 899 3

Liver transplant is the only effective treatment in the terminal liver disease. However, the complexity of the surgical technique and immunosuppression cause many neurologic complications. Three liver transplant recipients treated with cyclosporine developed a reversible neurologic syndrome characterized by early dysarthria, which evolved to anarthria, and tetraparesis. Brain MRI disclosed hyperintense lesions, on T2, and proton density-weighted images, in basis pontis. The substitution of the cyclosporine for FK 506, or its reduction, led to the clinical improvement of the patients. Therefore, cyclosporine may cause central pontine myelinolysis, being dysarthria the first manifestation of neurotoxicity. The early recognition of speech disorders in liver transplant recipients that receive cyclosporine should prompt withdrawal of the drug to avoid possible neurological sequelae. Furthermore, the strict control of natremias before and after the transplant may help to reduce the incidence of this type of complications, since a synergyc osmotic mechanism cannot be ruled out.
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PMID:[Central pontine myelinolysis associated with cyclosporin in liver transplantation]. 988 20

Foix-Chavany-Marie syndrome (FCMS) is a distinct clinical picture of suprabulbar (pseudobulbar) palsy due to bilateral anterior opercular lesions. Symptoms include anarthria/severe dysarthria and loss of voluntary muscular functions of the face and tongue, and problems with mastication and swallowing with preservation of reflex and autonomic functions. FCMS may be congenital or acquired as well as persistent or intermittent. The aetiology is heterogeneous; vascular events in adulthood, nearly exclusively affecting adults who experience multiple subsequent strokes; CNS infections; bilateral dysgenesis of the perisylvian region; and epileptic disorders. Of the six cases reported here, three children had FCMS as the result of meningoencephalitis, two children had FCMS due to a congenital bilateral perisylvian syndrome, and one child had intermittent FCMS due to an atypical benign partial epilepsy with partial status epilepticus. The congenital dysgenetic type of FCMS and its functional epileptogenic variant share clinical and EEG features suggesting a common pathogenesis. Consequently, an increased vulnerability of the perisylvian region to adverse events in utero is discussed. In honour of Worster-Drought, who described the clinical entity in children 40 years ago, the term Worster-Drought syndrome is proposed for this unique disorder in children.
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PMID:Foix-Chavany-Marie (anterior operculum) syndrome in childhood: a reappraisal of Worster-Drought syndrome. 1069 30

We report a very rare case of pure anarthria with lesion analysis. A 44-year-old right-handed man suffered from a cerebral infarction with a mild right hemiparesis and speech disturbance. An MRI of the brain 1.5 months post onset revealed a lesion confined to the left central gyrus. One month after the onset, his spontaneous speech was dysprosodic and laborious. It was contaminated with dysarthria and phonological paraphasias. However, language comprehension, repetition and naming abilities were normal. Most remarkably he showed no impairment in writing with his left hand. Over the following months, his difficulties in verbal output showed general amelioration, but the isolated impairment in the domain of articulation characterized by dysprosody, dysarthria, and phonological paraphasia persisted. As for the symptomatology of pure anarthria resulting from precentral gyral lesions, there have been controversies about its pureness. Some argue that the so called pure anarthria always shows some degree of writing disturbances, albeit mild in degree. Others maintain there certainly exists the pure type without any signs of agraphia. In the present case lesions were limited to the central gyrus but spared the lowest opercular portion. The previous reports of pure anarthria that had mild agraphia all had lesions involving the opercular portion. We conclude the sparing of this area is most likely related with sparing of writing capacity in pure anarthria.
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PMID:[The left central gyral lesion and pure anarthria]. 1100 29


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