Neurogenic stuttering as a manifestation of stroke and a mask of dysphonia.
R. L. was a 52-year-old man who was referred for an SLP consultation to determine the nature of his fluency disorder, whether or not treatment would be beneficial, and finally whether resumption of pre-trauma vocational status was feasible. The patient was involved in a motor vehicle accident with no resulting detectable trauma. However, shortly after the accident, R. L. developed a severe dysfluency that was later described as cortical stuttering. We reviewed the medical and rehabilitation work-up that attempted to determine whether the communication disorder was functional or organic in origin. Once the fluency disorder was determined to be caused by a suspected small, focal, hemispheric lesion, a five-month treatment program was undertaken that used a noval prosthetic approach to restore fluency. Once fluency was restored with the use of an artificial larynx, a residual anomia was detected and treated. The case of R. L. illustrates a stuttering that appeared to be caused by a combined neurogenic dyspraxic (vocal control), dysarthric (motor control), and dysnomic (word-finding) dysfluency. The literature on this issue was reviewed and the underlying mechanism of recovery was discussed.
Rao
P R
PR
Stroke Recovery Program, National Rehabilitation Hospital, Washington, D.C. 20010.
D000849:Anomia / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D002540:Cerebral Cortex / Q000503:physiopathology; D002561:Cerebrovascular Disorders / Q000150:complications* / Q000503:physiopathology / Q000534:rehabilitation; D004292:Dominance, Cerebral / Q000502:physiology; D004401:Dysarthria / Q000209:etiology / Q000503:physiopathology / Q000534:rehabilitation; D016489:Head Injuries, Closed / Q000150:complications / Q000503:physiopathology / Q000534:rehabilitation; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D012050:Rehabilitation, Vocational; D013342:Stuttering / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation; D014832:Voice Disorders / Q000209:etiology* / Q000503:physiopathology / Q000534:rehabilitation