Two Cases of Palilalia

Transcription

1 Two Cases of Palilalia Hyanghee Kim, Ph.D., Soo-Jin Cho, M.D., Won-Yong Lee, M.D., Duk L. Na, M.D., Kwang-Ho Lee, M.D. Department of Neurology, Samsung Medical Center, Sungkyunkwan University School of Medicine Palilalia is characterized mainly by compulsive repetitions of words and phrases, which are attenuated in loudness and increased in rate. Up to date, approximately 29 cases of palilalia secondary to various neurological insults were reported mostly as a single case study. To our knowledge, there has been no reported case of palilalia in Korea until now. In this report, we present two patients with palilalia. The first patient KH, a 52-year-old man, with vascular parkinsonism, exhibited the repetition after an episode of stroke in the bilateral basal ganglia area. The second patient SH, a 60-year-old man with idiopathic Parkinson s disease, also manifested the repetition of words and phrases. The speech performance of both patients varied with the type of speech tasks, for instance, propositional language as opposed to automatic language. Palilalia should be differentlly diagnosed from neurogenic stuttering, echolalia, or aphasic perseveration. A pathophysiological explanation of patient KH s palilalia would be an widespread extrapyramidal impairment that resulted in destruction of the inhibitory motor circuit which might lead to the abnormal, uncontrolled speech-related neuronal firing in the frontal lobe. On the other hand, patient SH s palilalic speech may result from hyperexcitation of downstream of dopaminergic system related to peak-dose dyskinesia. J Kor Neurol Ass 17(2):303~308, 1999 Key Words : Palilalia, Vascular parkinsonism, Parkinson s disease, Basal ganglia Hyanghee Kim, Ph.D., CCC-SLP Copyright 1999 by the Korean Neurological Association 303

2 Figure 1. T2-weighted axial and sagittal views of brain MRI of patient KH show basal ganglia lesions bilaterally Figure 2. Micrographic writing by patient KH. 304 J Kor Neurol Ass / Volume 17 / March, 1999

3 Table 1. Transcribed language sample on a conversation task between the patient KH and a speech-language pathologist. Speech-Language Pathologist Patient J Kor Neurol Ass / Volume 17 / March,

4 Table 2. Transcribed reading of standard passageautumnperformed by patient KH. Table 3. Transcribed language sample on a conversation task between the patient SH and a speech-language pathologist. Speech-Language Pathologist P a t i e n t 306 J Kor Neurol Ass / Volume 17 / March, 1999

5 Table 4. Transcribed reading of standard passage Autumnperformed by patient SH. 02. Kluin KJ, Foster NL, Berent S, Gilman S. Perceptual 01. LaPointe LL, Horner J. Palilalia: a descriptive study of pathological reiterative utterances. J Speech Hear Res 1981;46: analysis of speech disorders in progressive supranuclear palsy. Neurology 1993;43: Ackerman H, Ziegler W, Oertel W. Palilalia as a symptom of L-DOPA induced hyperkinesia. J Neurol Neurosurg J Kor Neurol Ass / Volume 17 / March,

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