Phenomenology of abnormal movements in stuttering.
BACKGROUND
Stuttering is often accompanied by involuntary movements, abnormal gestures or changes in facial expression.


OBJECTIVE
To describe the incidence and phenomenology of abnormal movements (AMs) in stuttering patients.


METHODS
Eighty-five consecutive patients with stuttering and 119 normal controls videotaped and subsequently reviewed, in which AMs were classified as voluntary or involuntary, and as concurrent or unrelated to speech. Movement phenomenology was correlated with disease severity.


RESULTS
Of 85 stuttering patients studied, 51.7% had AMs and 22 more than one AM. Sixty-six different AMs were identified, of which 83.3% occurred during speech, 72.7% were classified as involuntary, and 27.2% as voluntary. Of 38 involuntary movements concurrent to speech, 25 were originally perceived as voluntary, but had since become involuntary through repeated use during stuttering. All involuntary movements not concurrent to speech fulfilled criteria for tics.


CONCLUSIONS
AMs occurring during stuttering were not always involuntary; movements not concurrent with speech clearly fulfilled clinical criteria for tics and were similar in incidence to normal controls. Inverse correlation was found between conscious control of movement during speech and stuttering severity. Many involuntary movements occurring during speech were clearly referred by patients as initially voluntary early on in the development of their speech disorder (starters or unblockers), underlining the importance of repetitive use of complex motor sequences as a source for putative involuntary movement genesis.
Riva-Posse
Patricio
P
Neuroscience Department, Movement Disorders Section, Raúl Carrea Institute for Neurological Research, FLENI, Montañeses 2325, 1428AQK, Ciudad de Buenos Aires, Argentina.
Busto-Marolt
Laura
L
Schteinschnaider
Angeles
A
Martinez-Echenique
Lucia
L
Cammarota
Angel
A
Merello
Marcelo
M
D000293:Adolescent; D000328:Adult; D000704:Analysis of Variance; D002648:Child; D020820:Dyskinesias / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012720:Severity of Illness Index; D016037:Single-Blind Method; D013068:Speech Production Measurement; D013070:Speech Therapy / Q000379:methods; D013342:Stuttering / Q000150:complications* / Q000453:epidemiology / Q000628:therapy; D014743:Videotape Recording