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2.
Rev Neurol (Paris) ; 163(12): 1200-8, 2007 Dec.
Artículo en Francés | MEDLINE | ID: mdl-18355467

RESUMEN

INTRODUCTION: Dysarthria is a frequent cause of handicap for patients with traumatic brain injury. Clinical assessment and quantification of the disorder is necessary before treatment. METHODS: We report a perceptual analysis of speech in a population of 18 patients with traumatic brain injury, in comparison with 18 control subjects. Evaluation was provided with a 33-item clinical scale. RESULTS: Interjuge reliability was good. Speech analysis distinguished controls from patients. Main perceptual deviances were impairment of naturalness, prosodic and phonetic disturbances.


Asunto(s)
Lesiones Encefálicas/complicaciones , Disartria/diagnóstico , Disartria/etiología , Pruebas de Articulación del Habla , Adolescente , Adulto , Anciano , Trastornos de la Articulación/clasificación , Trastornos de la Articulación/diagnóstico , Trastornos de la Articulación/etiología , Disartria/clasificación , Femenino , Escala de Coma de Glasgow , Humanos , Masculino , Persona de Mediana Edad , Examen Neurológico , Variaciones Dependientes del Observador , Enfermedad de Parkinson/complicaciones , Estado Vegetativo Persistente/fisiopatología , Reproducibilidad de los Resultados , Percepción del Habla/fisiología
3.
J Neurol ; 253(1): 92-7, 2006 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-16096817

RESUMEN

OBJECTIVE: To characterize the dysarthria in patients with corticobasal degeneration (CBD) and determine if analysis of speech in isolation helps to distinguish CBD patients from patients with Parkinson's disease (PD). METHODS: 60 subjects were assessed by means of perceptual analysis of speech: 15 patients with CBD, 15 patients with PD and 30 control subjects. A detailed profile was furnished with the help of 33 perceptual items. A global perceptual approach was used to classify patients by judges blind to the medical diagnosis. Rating scales were adapted to quantify the degree of spasticity and hypokinesia in the speech of each patient. RESULTS: Dysarthria was frequent in CBD even though it remained mild for a long period of time. Group analysis revealed the importance of temporal errors of speech control in CBD patients while voice disturbances were most frequent in PD patients. However, attempts to classify patients according to global perceptual analysis remained below a reasonable level of clinical acceptability. Finally, even though the widespread neuropathological changes suggest that deviant speech dimensions of several types of dysarthria might be found in CBD, evidence for a mixed dysarthria with presence of spastic elements could not be established. CONCLUSION: The findings support the view that even though perceptual analysis is mandatory in the management of dysarthric patients, it does not help in the clinical differential diagnosis of CBD.


Asunto(s)
Disartria/diagnóstico , Disartria/etiología , Enfermedades Neurodegenerativas/complicaciones , Enfermedad de Parkinson/complicaciones , Percepción del Habla , Anciano , Diagnóstico Diferencial , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedades Neurodegenerativas/diagnóstico , Enfermedad de Parkinson/diagnóstico , Medición de la Producción del Habla/métodos
4.
Rev Neurol (Paris) ; 161(8-9): 857-61, 2005 Sep.
Artículo en Francés | MEDLINE | ID: mdl-16244572

RESUMEN

INTRODUCTION: Dysarthria is frequent in Parkinson's disease and impairs communication. STATE OF THE ART: Use of levodopa or surgical procedures does not significantly improve speech. Traditional speech therapy can lead to improvement of dysarthria, and intensive programs have recently showed substantial beneficial effects on parkinsonian dysarthria. PERSPECTIVES: More work is needed to evaluate speech treatment efficacy. CONCLUSION: Earlier and more frequent speech therapy in parkinsonian dysarthria patients may contribute to better quality of life.


Asunto(s)
Disartria/etiología , Disartria/terapia , Enfermedad de Parkinson/complicaciones , Logopedia/métodos , Humanos
6.
Rev Neurol (Paris) ; 158(4): 431-8, 2002 Apr.
Artículo en Francés | MEDLINE | ID: mdl-11984485

RESUMEN

Perceptual analysis is widely used in clinical practice to assess motor speech disorders such as dysarthria. Unfortunately, there is no standardised tool available in French. The purpose of this study was first to develop a perceptual rating system modelled after systems currently used in the English literature and second to determine its reliability. We evaluated 33 dimensions using a 5-point scale. The production of 10 dysarthric patients were rated by 9 clinicians during both spontaneous speech and a reading task. Intra judge reliability (at 1-point) was about 90 percent, while inter judge reliability was about 80 percent. Ratings were comparable for the spontaneous speech and the reading task. Perceptual analysis of dysarthria is an easy and reproducible approach that can be used for the initial evaluation and for the follow up of dysarthric patients.


Asunto(s)
Disartria/diagnóstico , Inteligibilidad del Habla , Encuestas y Cuestionarios , Adulto , Anciano , Disartria/epidemiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Lectura , Reproducibilidad de los Resultados , Factores de Tiempo , Conducta Verbal
7.
Folia Phoniatr Logop ; 53(1): 48-57, 2001.
Artículo en Inglés | MEDLINE | ID: mdl-11125260

RESUMEN

Voice onset time (VOT) reflects the timing control between laryngeal and supralaryngeal adjustments. It has been studied both in normal speakers and patients with speech disorders, but very little information has been published on the feasibility of this measure in clinical practice. We examined 10 repeated utterances involving the voiceless stop consonants [p], [t] and [k] in 110 subjects (27 controls, 48 with spastic dysarthria and 35 with hypokinetic dysarthria). The mean rate of measurable VOT was 95% for normal speech, 80% for hypokinetic dysarthria and 84% for spastic dysarthria. The main obstacle to successful measurement was lack of the burst signifying the release of the plosive. The posterior stop [k] presented the greatest measurement difficulties for the dysarthric subjects, which is in accordance with previous perceptual reports on dysarthria.


Asunto(s)
Disartria/diagnóstico , Fonética , Espectrografía del Sonido , Acústica del Lenguaje , Anciano , Anciano de 80 o más Años , Disartria/etiología , Femenino , Humanos , Masculino , Persona de Mediana Edad , Valores de Referencia , Medición de la Producción del Habla
8.
Mov Disord ; 15(5): 905-10, 2000 Sep.
Artículo en Inglés | MEDLINE | ID: mdl-11009198

RESUMEN

The authors evaluated dysarthria and orofacial apraxia (OFA) in 10 patients with a clinical diagnosis of corticobasal degeneration (CBD). Nine patients were slightly dysarthric according to the French version of the Frenchay Dysarthria Assessment, which evaluates the motricity of the components of the vocal tract. The severity of dysarthria assessed by an intelligibility score was correlated to the global severity of the disease, but not to the duration of the disease. Voluntary movements of the tongue and the lips were impaired in all patients. OFA, evaluated with simple and sequential gestures, was present in nine patients. Sequential gestures were more frequently impaired. The score of OFA was not correlated to the severity of dysarthria, suggesting independent underlying mechanisms. Thus, when specifically assessed, dysarthria and OFA are more frequent in CBD than usually reported. We propose that the underlying pathophysiology is the result of a deficit in programming and execution of repetitive movements.


Asunto(s)
Apraxias/etiología , Enfermedades de los Ganglios Basales/complicaciones , Disartria/etiología , Enfermedades Neurodegenerativas/complicaciones , Inteligibilidad del Habla , Anciano , Enfermedades de los Ganglios Basales/fisiopatología , Corteza Cerebral/fisiopatología , Femenino , Francia , Humanos , Masculino , Enfermedades Neurodegenerativas/fisiopatología , Pruebas Neuropsicológicas , Trastornos Parkinsonianos/etiología , Escalas de Valoración Psiquiátrica , Índice de Severidad de la Enfermedad
9.
Presse Med ; 29(19): 1043-4, 2000.
Artículo en Francés | MEDLINE | ID: mdl-10874911

RESUMEN

BACKGROUND: Lithium salts can induce a dysfunction of the neuromuscular junction. CASE REPORT: A patient given lithium for bipolar psychosis developed a state of major fatigue revealing a myasthenia syndrome which resolved progressively after lithium withdrawal. DISCUSSION: In the literature, we found 4 cases of neuromuscular junction disorders in patients treated with lithium. A myasthenia syndrome was induced by lithium in 3 cases and underlying myasthenia was disclosed by lithium in the last one. The long-term course in our patient was in favor of an induced syndrome rather than underlying myasthenia. We discuss the pathophysiological mechanisms. Lithium is a commonly prescribed drug. Clinicians should be aware of the possibility of neuromuscular junction disorder in patients taking lithium who develop muscle fatigue.


Asunto(s)
Antimaníacos/efectos adversos , Litio/efectos adversos , Miastenia Gravis/inducido químicamente , Ansiolíticos/uso terapéutico , Benzodiazepinas , Trastorno Bipolar/tratamiento farmacológico , Carbamazepina/uso terapéutico , Fatiga/inducido químicamente , Humanos , Masculino , Persona de Mediana Edad , Debilidad Muscular/inducido químicamente , Unión Neuromuscular/efectos de los fármacos
10.
Rev Chir Orthop Reparatrice Appar Mot ; 86(2): 188-92, 2000 Apr.
Artículo en Francés | MEDLINE | ID: mdl-10804417

RESUMEN

Isolated palsy of the musculocutaneous nerve, terminal branch of the lateral cord of the brachial plexus, is rare. It is responsible for sensory loss of the distal forearm and weakness of elbow flexion. It occurs after shoulder or clavicle surgery, trauma (fracture, dislocation, blows on the shoulder), violent exercice or extension of the forearm, prolonged positioning of the shoulder in extension-abduction-external rotation and phlebotomy. Different mechanisms such as stretching, compression or direct nerve injury are encountered. We report 5 cases with isolated musculocutaneous nerve palsy, including bilateral palsy caused by violent forearm extension. In other cases, mechanisms were an extensive stretching during surgery and compression caused by prolonged supine position. Different injury locations and causes described in literature are reviewed.


Asunto(s)
Traumatismos del Brazo/complicaciones , Mononeuropatías/etiología , Nervio Musculocutáneo/lesiones , Accidentes de Tránsito , Adulto , Femenino , Humanos , Masculino , Parálisis/etiología
11.
Rev Neurol (Paris) ; 156(1): 47-52, 2000 Jan.
Artículo en Francés | MEDLINE | ID: mdl-10693258

RESUMEN

Perceptual analysis is not sufficient enough to identify specific dysarthria types. In order to improve the discrimination between dysarthria types, we developed a standardized evaluation of different functions controlling speech motor performances. This was applied to 90 patients suffering from hypokinetic, spastic or ataxic dysarthria and 15 control subjects. A discriminate analysis showed that 71.4 p. 100 of the cases were correctly classified. This model was validated within a new group of 21 patients and showed that the less severe dysarthric parkinsonian patients were difficult to distinguish from control subjects. The discriminate analysis was then used for 20 patients with atypical parkinsonism. Seven patients with progressive supranuclear palsy were considered to have hypokinetic dysarthria. The 6 patients with multisystem atrophy and 7 with corticobasal degeneration were classified among the 3 dysarthric types. We suggest that motor speech evaluation may contribute to differential diagnosis within groups of patients suffering from atypical parkinsonism.


Asunto(s)
Disartria/diagnóstico , Anciano , Anciano de 80 o más Años , Diagnóstico Diferencial , Disartria/complicaciones , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/complicaciones , Enfermedad de Parkinson/diagnóstico , Parálisis Supranuclear Progresiva/complicaciones , Parálisis Supranuclear Progresiva/diagnóstico
12.
Rev Neurol (Paris) ; 155(12): 1007-20, 1999 Dec.
Artículo en Francés | MEDLINE | ID: mdl-10637921

RESUMEN

Cortico-basal degeneration (CBD) has recently emerged as a distinctive entity of the Parkinson-plus syndromes but presents with great clinical and anatomopathological heterogeneity. The purpose of this review is to increase awareness of the syndrome and facilitate its recognition in both typical and unusual cases. We will herein review the 398 cases found in the English and French literature with their clinical, laboratory and pathological features.


Asunto(s)
Enfermedades de los Ganglios Basales/patología , Corteza Cerebral/patología , Degeneración Nerviosa/patología , Anciano , Femenino , Humanos , Masculino , Persona de Mediana Edad , Enfermedad de Parkinson/diagnóstico
13.
Rev Neurol (Paris) ; 154(10): 683-9, 1998 Oct.
Artículo en Francés | MEDLINE | ID: mdl-9846338

RESUMEN

We report the naming performances of a 25 year-old woman with a left internal and inferior temporal lesion caused by herpes encephalitis who showed a preferential impairment for naming man-made objects. Evidence for category-specific effect was provided by a stepwise logistic regression using 171 pictures characterized by several parameters (words frequency, diversity of responses, length, name agreement, majoritary response, familiarity, visual complexity and canonicity). Analyses were realized over a 5 month period. Methodological considerations, anatomic correlations and arguments suggesting lexical access or semantic storage disturbance are discussed.


Asunto(s)
Afasia/virología , Encefalitis Viral/psicología , Infecciones por Herpesviridae/psicología , Adulto , Femenino , Humanos , Modelos Logísticos , Análisis de Regresión
14.
Rev Neurol (Paris) ; 154(6-7): 523-30, 1998 Jul.
Artículo en Francés | MEDLINE | ID: mdl-9773085

RESUMEN

We adapted in French the Frenchay Dysarthria Assessment (FDA) developed by P. Enderby in 1983. This tool quantitatively evaluates the organs involved in speech and provides a measurement of intelligibility. Productions of normal subjects were analyzed. Reproductibility of data (correlation and interobserver concordance) was high in 18 dysarthric patients. A study performed in 100 dysarthric patients corresponding to 4 types of dysarthria (spastic, ataxic, hypokinetic and mixte) showed that dysarthria resulted from a global impairment of organs implied in speech, rather than one specific organ. The reduction in the intelligibility score was related to organ impairment.


Asunto(s)
Disartria/psicología , Pruebas de Discriminación del Habla , Inteligibilidad del Habla , Anciano , Disartria/clasificación , Disartria/fisiopatología , Femenino , Francia , Humanos , Masculino , Persona de Mediana Edad , Variaciones Dependientes del Observador , Valores de Referencia , Reproducibilidad de los Resultados
18.
Presse Med ; 26(16): 756-8, 1997 May 17.
Artículo en Francés | MEDLINE | ID: mdl-9205470

RESUMEN

BACKGROUND: Non-bacterial thrombotic endocarditis in patients with cancer can lead to ischemic stroke. Endocardial vegetations are usually small and may be missed at transthoracic echocardiography. CASE REPORT: Disseminated intravascular coagulation developed in a woman with ischemic stroke. Transthoracic echocardiography was normal. Four days later, transesophageal echocardiography revealed a large mitral vegetation suggesting non-bacterial thrombotic endocarditis. The diagnosis was confirmed at pathology which reported carcinoma of the colon. DISCUSSION: Transthoracic echocardiography is rarely contributed to the diagnosis of thrombotic endocarditis. In our patient transesophageal echocardiography grave the diagnosis before death instead of retrospectively at autopsy as usually occurs, demonstrating the value of transesophageal echocardiography for cancer patients who develop ischemic stroke.


Asunto(s)
Isquemia Encefálica/etiología , Endocarditis/complicaciones , Trombosis/complicaciones , Adenocarcinoma/complicaciones , Anciano , Isquemia Encefálica/diagnóstico por imagen , Neoplasias del Colon/complicaciones , Ecocardiografía Transesofágica , Endocarditis/diagnóstico por imagen , Femenino , Humanos , Trombosis/diagnóstico por imagen
19.
J Radiol ; 78(3): 219-22, 1997 Mar.
Artículo en Francés | MEDLINE | ID: mdl-9113149

RESUMEN

Complete disappearance of a cerebral arteriovenous malformation (AVM), 9 years after its discovery, is reported in a 45-year-old man. This unusual evolution was revealed by the onset of 3 seizures. CT scan and MR imaging eliminated any hemorrhage and carotid angiography showed the spontaneous thrombosis of the whole malformation. The evolution of the MRI signals demonstrates that seizures and the disappearance of the AVM were concomitant. It is suggested that the spontaneous thrombosis of the venous drainage caused the AVM disappearance with cerebral oedema responsible of seizures.


Asunto(s)
Malformaciones Arteriovenosas Intracraneales/fisiopatología , Embolia y Trombosis Intracraneal/etiología , Epilepsia Generalizada/etiología , Epilepsia Generalizada/fisiopatología , Humanos , Embolia y Trombosis Intracraneal/fisiopatología , Angiografía por Resonancia Magnética , Masculino , Persona de Mediana Edad , Remisión Espontánea , Factores de Tiempo , Tomografía Computarizada por Rayos X
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