Two Cases of Palilalia

ABSTRACT

BACKGROUND: Palilalia is characterized mainly by compulsive repetitions of words and phrases, which are attenuated in loudness and increased in rate. Up to date, approximately 29 cases of palilalia secondary to various neurological insults were reported mostly as a single case study. To our knowledge, there has been no reported case of palilalia in Korea until now. In this report, we present two patients with palilalia. CASES The first patient KH, a 52-year-old man, with vascular parkinsonism, exhibited the repetition after an episode of stroke in the bilateral basal ganglia area. The second patient SH, a 60-year-old man with idiopathic Parkinson's disease, also manifested the repetition of words and phrases. The speech performance of both patients varied with the type of speech tasks, for instance, propositional language as opposed to automatic language. COMMENT: Palilalia should be differentlly diagnosed from neurogenic stuttering, echolalia, or aphasic perseveration. A pathophysiological explanation of patient KH's palilalia would be an widespread extrapyramidal impairment that resulted in destruction of the inhibitory motor circuit which might lead to the abnormal, uncontrolled speech-related neuronal firing in the frontal lobe. On the other hand, patient SH's palilalic speech may result from hyperexcitation of downstream of dopaminergic system related to peak-dose dyskinesia.