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Questions for part B
Published in Henry J. Woodford, Essential Geriatrics, 2022
An 83-year-old woman presented to hospital with an acute onset of slurred speech, poor balance and difficulty swallowing. A CT scan at that time showed a cerebellar bleed. The next day she deteriorates and is hard to rouse. Her blood glucose is in the normal range. What is the most important thing to exclude next?Cardiac arrhythmiaEpilepsyFourth ventricle compressionIschaemic strokeRe-bleeding
Chronic Fatigue Syndrome: Limbic Encephalopathy in a Dysregulated Neuroimmune Network
Published in Jay A. Goldstein, Chronic Fatigue Syndromes, 2020
CFS patients sometimes complain of slurred speech, particularly when fatigued. This dysarthria appears to be of the lower motor neuron type, as is seen in lesions of the lower pons or medulla. Since they do not seem to have cortical dysarthrias I can only speculate about how modulation of neural tone through descending tracts may cause this disorder. Slurred speech has been described, however, in temporolimbic epilepsy.
Neurofeedback in an Integrative Medical Practice
Published in Hanno W. Kirk, Restoring the Brain, 2020
9-year-old boy presented with a 2-year history of generalized tonic-clonic seizures and nocturnal Rolandic seizures that occur at least weekly while on medications. EEG showed multifocal sharp-wave discharges in multiple brain areas, including mid-central, mid-parietal, right temporal, and left parietal regions. MRI showed right hippocampal sclerosis. For religious reasons, the patient’s family wanted to have him off medications, but they agreed to start medicine after an episode of status epilepticus that resulted in hospitalization about 6 months prior to presentation for neurofeedback treatment. Mother observed that medications (Trileptal and Lamictal) have caused side effects of slurred speech, tremors, poor motor coordination, decreased processing speed, and fatigue.
Do people with Myasthenia Gravis need speech-language pathology services? A national survey of consumers’ experiences and perspectives
Published in International Journal of Speech-Language Pathology, 2022
Kirstine Shrubsole, Chloe Davies, Katrina L. Williams
The majority of respondents reported symptoms of speech difficulties including the following: overall weakness after talking for a long time (73.9%), slurred speech (55.0%), unclear speech (45.1%), a change in facial expression (47.8%), and weakness in the face, cheeks or lips (66.7%). Only nine people (8.1%) reported they had never experienced changes to their speech or facial weakness as a result of their MG. A total of 107 people completed the Dysarthria Impact Profile (DIP), with 72 responding to more than two-thirds of the statements (the remaining 35 had a large number of “n/a” responses and were excluded from this section of analysis). Of the 72 included responses, the mean score of the DIP was 3.31, indicating that on average most respondents felt some negative psychosocial impact of dysarthria. Six people (8.3%) had mean scores above 4 indicating worse impact.
Sports Related Concussion Impacts Speech Rate and Muscle Physiology
Published in Brain Injury, 2021
Russell E. Banks, Deryk S. Beal, Eric J. Hunter
To the untrained listener, changes in speech timing and coordination are often perceived as “slurred speech.” Slurred speech is widely recognized by contact sport referees as an on-field sign that an athlete has sustained an SRC (14). The most frequently cited sideline assessments and guidelines list slurred speech as a physical sign of acute SRC and encourage that speech be monitored at follow-up (15–18). Surprisingly, no operational definition of slurred speech as it pertains to SRC has been established and no protocol exists to assess speech motor control in SRC. Establishing a meaningful and efficient speech evaluation to inform current comprehensive SRC assessments could improve diagnostics and prognostics for affected athletes, as underscored by the call for speech analyses in SRC by the American Medical Society for Sports Medicine’s (AMSSM) (17).
Novel mutation in the KCNJ10 gene in three siblings with seizures, ataxia and no electrolyte abnormalities
Published in Journal of Neurogenetics, 2018
Muna A. Al Dhaibani, Ayman W. El-Hattab, Kathryn B. Holroyd, Jennifer Orthmann-Murphy, Valerie A. Larson, Khurram A. Siddiqui, Miklos Szolics, Nicoline Schiess
Neuropsychological testing at age 19 showed borderline to low average abilities in verbal comprehension (2nd percentile), perceptual reasoning (3rd percentile) and processing speed (3rd percentile) (WAIS-IV test) with low scores on immediate memory, attention, and language indices (RBANS test). Neurological examination demonstrated slurred speech with separated syllables, increased tone, and decreased vibratory sensation in the lower extremities. Dysmetria and dysdiadochokinesia were present, but there was no tremor. Deep tendon reflexes were brisk, with positive Hoffman bilaterally. She was unable to perform tandem walk or toe walk, and had a positive Romberg sign. Brain MRI, reviewed by two neuroradiologists, showed subtle mild diffuse cerebral and mild superior cerebellar as well as brain stem and cervical cord atrophy.