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The Problems
Published in John Greene, Ian Bone, Understanding Neurology a problem-orientated approach, 2007
There are two types of cerebellar dysarthria, one characterized by ‘explosive’ speech as if the patient was speaking with his mouth full of marbles. The other type of speech is much slower with undue separation of the syllables, known as staccato or scanning speech (from a resemblance to the scanning of the Greek verse). The former is more characteristic of an acquired cerebellar problem (e.g. multiple sclerosis) and occurs because the patient attempts to speak normally but suffers from poor coordination of the muscles of articulation of speech and control of breathing. Scanning speech is relatively more common in either a developmental cerebellar disease (congenital or the early-onset type of heredofamilial ataxia) or a lesion acquired early in childhood. Cerebellar disease is often associated with distinctive eye movement abnormalities and nystagmus; these are discussed elsewhere (page 104).
Mechanisms of COVID-19-induced cerebellitis
Published in Current Medical Research and Opinion, 2022
Mohammad Banazadeh, Sepehr Olangian-Tehrani, Melika Sharifi, Mohammadreza Malek-Ahmadi, Farhad Nikzad, Nooria Doozandeh-Nargesi, Alireza Mohammadi, Gary J. Stephens, Mohammad Shabani
In the research by Werner et al. the patient appeared with the cerebellar syndrome, slightly scanning speech, and limb-, truncal-, and gait ataxia upon admission 16 days after the beginning of COVID-19 respiratory disease and 1 day after the remission of COVID-19 upper respiratory symptoms. They reported a case of cerebellar syndrome, with other aspects normal60. In the research by Ciolac et al. a patient’s neurological condition was evaluated, which indicated bilateral limb ataxia, with the left limbs being more severely affected, bulbar palsy (mostly dysphonia and dysphagia), a diminished gag reflex, and the absence of nystagmus. The patient’s cerebellar and bulbar syndromes gradually recovered over the following two weeks, whereas cognitive and behavioral impairment continued. Cognitive impairment was distinguished by diminished visuospatial skills, linguistic fluency, and focus. Behavioral impairment was marked by periods of abrupt yelling, chest-beating, poor judgment and insight, and lack of restraint (i.e. inappropriate naked body postures, urinating in the room, etc.). The neuropsychological evaluation revealed modest cognitive impairment (23 on the Montreal Cognitive Assessment), moderate depression (19 on the Beck Depression Inventory), and minimal anxiety (Hamilton Anxiety Rating Scale score: 9)43.
Pharmacotherapy for the management of the symptoms of Machado-Joseph Disease
Published in Expert Opinion on Pharmacotherapy, 2022
Jessica Blanc Leite Oliveira, Alberto R.M. Martinez, Marcondes Cavalcante França Jr
Gait instability typically heralds the onset of SCA3/MJD, followed by signs of limb incoordination [8]. Intentional tremor may be prominent in some individuals. Scanning speech, dysphagia, and truncal ataxia are also typical of SCA3/MJD but tend to develop later. In clinical practice, ataxia severity is assessed using clinical tools, the most frequent of which are the Scale for Assessment and Rating of Ataxia (SARA) [9], Neurological Examination Score for the Assessment of Spinocerebellar Ataxia (NESSCA) [10] and the Brief Ataxia Rating Scale (BARS) [11].
Neuroanniversary 2018
Published in Journal of the History of the Neurosciences, 2018
Jean Martin Charcot (1825–1893) described in his article “Histologie de la sclérose en plaques,” appearing in 1868 in Gazette des Hôpitaux, three characteristic symptoms of multiple sclerosis, also referred to as Charcot’s triad: nystagmus, intention tremor, and telegraphic speech (scanning speech).