Central nervous system lesions
E Glucksman in MCQs in Neurology and Neurosurgery for Medical Students, 2022
Central pontine myelinolysis is a fatal complication that is due to rapid correction of hyponatraemia. An acute onset of paralysis, dysarthria, dysphagia, diplopia and eventual loss of consciousness may occur following correction. Clinical vasospasm can present with a reduced Glasgow Coma scale score or delayed ischaemic neurological deficit (stroke) and is considered to occur as a result of irritation of the blood vessels by the subarachnoid blood. If the mass enlarges further, it exceeds the critical level and the Intracranial Pressure (ICP) then increases very rapidly as auto-regulation fails. In these patients, mannitol (a diuretic) can be used to reduce the ICP prior to more definitive neurosurgical intervention. If the mass enlarges further, it exceeds the critical level and the ICP then increases very rapidly as auto-regulation fails. In these patients, mannitol (a diuretic) can be used to reduce the ICP prior to more definitive neurosurgical intervention.
Acquired Childhood Speech Disorders: Dysarthria and Dyspraxia
Bruce E Murdoch in Acquired Neurological Speech/Language Disorders In Childhood, 1990
Although the presence of an articulatory disturbance has often been noted in children with acquired aphasia (Alajouanine and Lhermitte, 1965; Ferro et al., 1982; Van Hout et al., 1985), it is typical that no indication is given as to whether this disturbance represents a form of dysarthria, dyspraxia or a phonological disorder. Consequently the literature on acquired speech disorders in children has little to offer the clinician in either the diagnosis or treatment of these children. While the difficulty of applying models and theories developed for adults with acquired neurological disorders to children, particularly those still acquiring language, is acknowledged, until more information becomes available to refute their appropriateness it appears that such models are all that is available, at this stage, to help clinicians in the assessment and treatment of children with acquired speech disorders.
Dementia Treated with Ginkgo
Ethan Russo in Handbook of Psychotropic Herbs, 2015
This eighty-year-old male was referred by his internist for cognitive evaluation. The patient saw his doctor in 1986 regarding a question of a stroke. The only thing he reported was an episode in which he had problems with word finding. He was on aspirin and dipyridamole at the time. It was noted that he walked on a wide base, with his legs splayed apart to maintain balance. His CT showed atrophy. His wife complained of possible Alzheimer’s disease because he displayed memory problems. He had some rectal and urinary incontinence and loss of libido. He had dysarthria with fatigue. Subsequently, a carotid ultrasound was normal, as was an EEG. He was continued on aspirin.
Living with acquired dysarthria: the speaker's perspective
Published in Disability and Rehabilitation, 2011
Purpose. To explore the speaker's experience of living with acquired chronic dysarthria. Method. Ten people with dysarthria and progressive neurological illness and one person with dysarthria following stroke were interviewed in depth about their experience of living with dysarthria. They covered a range of ages, time post-onset and dysarthria severity levels. Interviews were transcribed and analysed using Framework Method of Analysis. Results. Acquired dysarthria can negatively impact on speakers' lives. Findings here suggest that the experience of living with dysarthria is highly individual. There were some common perspectives. Six key themes emerged from interviews: ‘dysarthria as only part of the picture’, ‘communication has changed’, ‘people treat me differently’, ‘dysarthria resulting in negative emotions’, ‘barriers to communication’ and ‘life is different now. The impact of co-existing physical disability and the need to consider dysarthria in context was emphasised by all participants. Conclusion. Findings re-emphasise the need to consider the individual experience in clinical practice. The findings provide direction for assessment and intervention in the area.
Motor speech problems associated with stroke: The dysarthrias
Published in Topics in Stroke Rehabilitation, 1994
Dysarthria is one of a number of communication problems that may occur following a stroke. The presence of dysarthria can affect both rehabilitation efforts as well as social and vocational adjustment. This article reviews methods of classifying the dysarthrias and presents the types of dysarthria most often encountered poststroke. The characteristics of these dysarthria types are then related to the underlying neuropathology. Finally, a model of intervention that addresses the impairment, disability, and handicap of the dysarthria is presented. Specific examples of the role of the rehabilitation team in the management of dysarthria are provided.
Patients' experiences of disruptions associated with post‐stroke dysarthria
Published in International Journal of Language & Communication Disorders, 2008
Sylvia Dickson, Rosaline S. Barbour, Marian Brady, Alexander M. Clark, Gillian Paton
Background: Post‐stroke dysarthria rehabilitation should consider social participation for people with dysarthria, but before this approach can be adopted, an understanding of the psychosocial impact of dysarthria is required. Despite the prevalence of dysarthria as a result of stroke, there is a paucity of research into this communication disorder, particularly studies that address the experiences of individuals. The available literature focuses mainly on the perceptions of others or includes groups of mixed aetiologies. Aims: To investigate the beliefs and experiences of people with dysarthria as a result of stroke in relation to their speech disorder, and to explore the perceived physical, personal and psychosocial impacts of living with dysarthria. Methods & Procedures: Participants for this qualitative study were recruited from twelve hospitals in Scotland that served both rural and urban populations and afforded opportunity for comparison. Semi‐structured, in‐depth interviews were carried out over a 12‐month period with 24 individuals with varying severity of dysarthria following stroke. The interviews were orthographically transcribed and coded using the NVivo package, which also facilitated identification of patterns using the constant comparative method. Outcomes & Results: The results of the study indicate that the effects of dysarthria following stroke extend beyond the physiological characteristics of the impairment. In turn, the resulting communication difficulties lead to changes in self‐identity, relationships, social and emotional disruptions, and feelings of stigmatization or perceived stigmatization. The impact of dysarthria was found to be disproportionate to the physiological severity, with participants continually striving to get their speech back to ‘normal’. Conclusions & Implications: The findings provide insight into the psychosocial impact of dysarthria following stroke. Speech and language therapy interventions need to go beyond the speech impairment to address and promote psychosocial well being, reduce the likelihood of feelings of stigmatization and changes in self‐identity, irrespective of the severity of dysarthria.
Related Knowledge Centers
- Brainstem
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- Cranial Nerve
- Phonation
- Resonance
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