100 MCQs from Dr. Brenda Wright and Colleagues
David Browne, Selena Morgan Pillay, Guy Molyneaux, Brenda Wright, Bangaru Raju, Ijaz Hussein, Mohamed Ali Ahmed, Michael Reilly in MCQs for the New MRCPsych Paper A, 2017
A clang association is the association of speech directed by the sound of a word rather than by its meaning. It includes punning and rhyming speech and is most often seen in schizophrenia and mania. It has been suggested that the clang associations in the language disorder of schizophrenia involve the initial syllable of a previous word, while the clang in manic speech occurs in terminal syllables. Echolalia is the repeating of words or phrases of one person by another. It is particularly seen in catatonic schizophrenia. Metonymy involves the use of a word or phrase that is related to the proper one but not the one ordinarily used; for example the patient says he will eat a menu rather than a meal. Palilalia is the repetition of a word or phrase. It is a perseveratory phenomenon. Verbigeration is the meaningless and stereotyped repetition of words or phrases seen in schizophrenia. (5, p 167, 14, pp 849–59)
Associated disorders
Steve Hannigan in Inherited Metabolic Diseases: A Guide to 100 Conditions, 2018
In the atypical form of the disorder, the genetic alterations that lead to the condition have not yet been identiied, and the methods of inheritance are unclear. The symptoms of this form usually develop later, around adolescence, and progress more slowly than those of the classical form. The symptoms that are more likely to present irst are speech problems, including loss of the ability to speak clearly and form words (dysarthria), repetition of words or phrases (palilalia) and speaking rapidly (tachylalia). There may be changes in behaviour, such as mood swings, depression, impulsive behaviour and violent outbursts. As the condition progresses, the movement problems seen in the classical form develop, with diiculty in controlling movements and eventually loss of the ability to walk. Seizures are more likely to occur in the atypical form. The symptoms in this form of Hallervorden-Spatz syndrome show greater variation between individuals.
Echophenomena and Coprophenomena
Alexander R. Toftness in Incredible Consequences of Brain Injury, 2023
(STORY 3) A woman who had previously suffered from encephalitis lethargica began experiencing palilalia following her treatment with L-DOPA. She developed an uncontrollable tendency to repeat the things that she was saying. Her voice would rise from its normal soft and low-pitched state to one that was shrill and piercing as she shouted the same phrase over and over, such as “my arms, my arms, my arms, my arms, please move my arms, my arms, move my arms” (p. 52). During these attacks she felt “anguish and terror and shame” and tried to express that she was not controlling her voice during these attacks: “oh, oh, oh, oh … please don't … I'm not myself, not myself … It's not me, not me, not me at all” (Sacks, 1999, case FD, p. 52).
Stuttering and compulsive manipulation of tools after hemorrhage in the anterior corpus callosum and cingulate gyrus: a case study
Published in Speech, Language and Hearing, 2018
Tetsuo Tani, Naoki Wada
The primary characteristics of this patient's disfluency were blocks with struggle and repetition of syllables during the first disfluency test (see Table 2). These characteristics distinguish this form of disfluency from any utterance-based disorder following brain injury such as conduction aphasia or palilalia. Conduction aphasia is characterized by frequent occurrence of phonemic paraphasia. The disfluency blocks and syllable repetitions observed in the current patient consisted of correct pronunciation of syllables, which differs from mistakes in the choice of syllables, i.e., phonemic paraphasia. Palilalia is a phenomenon whereby one repeats a word and a phrase involuntarily. It gradually becomes a rapid utterance along with a low voice. Palilalia also occurs often in sentence-final contexts and is absent from reading. However, our patient had neither a rapid utterance or a low voice. Therefore, the disfluency exhibited by this patient seems to be neither conduction aphasia nor palilalia.
Manganese concentration in patients with encephalopathy following ephedrone use: a narrative review and analysis of case reports
Published in Clinical Toxicology, 2022
Michal Ordak, Natalia Sloniewicz, Tadeusz Nasierowski, Elzbieta Muszynska, Magdalena Bujalska-Zadrozny
de Bie et al. described the case of a 36-year-old man from Azerbaijan who noticed a decrease in his libido in 2005 [18]. In 2004, the patient began to self-inject a methcathinone solution prepared by combining pseudoephedrine hydrochloride with potassium permanganate. He used this solution one to two times a day. Soon after, the patient experienced excessive sleepiness and slowness of movement. These symptoms progressed rapidly for the first few months and then stabilized. The patient was difficult to understand due to palilalia. He did not drool but occasionally choked. He had difficulty walking but reported no problems with maintaining his balance. He had restless legs syndrome (RLS). The patient experienced difficulties in performing fine motor movements but had no gastrointestinal symptoms. The patient's manganese content was measured in whole blood (897 nmol/L) and urine (2804.3 nmol/24 h). Pramipexole dihydrochloride in doses up to 75 mg/day had no effect on Parkinsonism but relieved his RLS. He stopped taking this due to excessive daytime sleepiness and a craving for sweets. Selegiline hydrochloride and levodopa-carbidopa at doses of up to 600/150 mg/day were unsuccessful. Thereafter, a naturopathic physician treated him with a series of calcium disodium EDTA infusions without effect on his symptoms [18].
Gabrielle Lévy and the Roussy-Lévy syndrome
Published in Journal of the History of the Neurosciences, 2018
Peter J. Koehler
The clinical-anatomical method has played an important role in neurology at least since the mid-1800s and particularly in Charcot’s neurological school, of which Lévy’s teacher, Pierre Marie, was a disciple. Not only were elementary motor and sensory phenomena the subjects of clinical localization studies (and since the 1880s, this was often the method to apply in early neurosurgery done by a general surgeon in cooperation with a neurologist) but also higher cortical functions—including aphasia, apraxia, and agnosia—were localized. A number of articles by Lévy deal with what may be categorized as higher cortical functions. With Pierre Marie and Gustave Roussy, she published on palilalia, a speech disorder with involuntary repetition of syllables or words. They were not the first to do so, as was described previously with the term auto-echolalia (Marie & Lévy, 1925; Roussy & Lévy, 1931). Other articles were on spatial representation in apraxic patients (Lhermitte et al., 1925), cortical sensory disorders (Roussy & Lévy, 1930), pseudobulbar speech (in fact, not a cortical speech disorder; Lévy, 1930), several on peduncular hallucinosis, 34This is a kind of a release phenomenon with vivid, usually colored visual images that imitate true perception. Sufferers correctly identify the hallucinations and are aware of their unreality, in contrast to true visual hallucinations. It is caused by lesions in the brainstem and thalamus. It was first described by Jean Lhermitte and therefore eponymously associated with this name. including an anatomical-pathological description (Lhermitte & Lévy, 1931b, 1933; Lhermitte et al., 1932). According to Roussy, Lévy’s contribution in these publications, in particular those on peduncular hallucinosis, on which she worked with Jean Lhermitte, was not small.
Related Knowledge Centers
- Cluttering
- Coprolalia
- Prefrontal Cortex
- Basal Ganglia
- Echolalia
- Aphasia
- Tic
- Language Disorder
- Speech Disorder
- Stuttering