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Progressive dysfluency associated with right hemisphere disease.

J Horner, E W Massey

    Brain and Language
    |January 1, 1983
    PubMed
    Summary
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    A stroke survivor experienced progressive dysfluency, primarily word and phrase repetitions, resembling palilalia rather than stuttering. This highlights a specific neurological consequence of right hemisphere damage.

    Area of Science:

    • Neurology
    • Speech-Language Pathology

    Background:

    • Acquired dysfluencies can arise from cerebrovascular events.
    • Understanding the specific characteristics of post-stroke speech disorders is crucial for diagnosis and treatment.

    Observation:

    • A 62-year-old male presented with late-onset, progressive dysfluency after a right hemisphere stroke.
    • The dysfluency manifested as prominent word and phrase reiterations, with less frequent sound/syllable repetitions.
    • Speech patterns showed greater dysfluency in spontaneous speech compared to oral reading, repetition, recitation, or singing.

    Findings:

    • The patient exhibited reduced vocal loudness and increased speech rate during reiterations.
    • Reiterations occurred across all sentence positions (initial, medial, final).
    • The dysfluency pattern was more consistent with palilalia than acquired cortical stuttering, which typically features initial sound/syllable repetitions.

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    Implications:

    • This case suggests a specific subcortical projection system defect due to infarction in the right middle cerebral artery territory.
    • The findings contribute to the understanding of diverse speech impairments following focal brain injury.
    • Distinguishing between stuttering and palilalia in acquired dysfluency is essential for accurate neurological localization and rehabilitation planning.