Cases reported "Stuttering"

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1/7. Using simplified regulated breathing with an adolescent stutterer: application of effective intervention in a residential context.

    Simplified regulated breathing (SRB) has been demonstrated to reduce or eliminate stuttering in children. However, much of the current research has evaluated the intervention with school-aged children within educational contexts. In the current case report, we extended the application of SRB by evaluating its effectiveness in treating stuttering displayed by a 15-year-old resident of a large midwestern residential facility. Further, we evaluated the impact across different assessment conditions. Results showed that SRB resulted in decreased stuttering for the participant, although differential effectiveness across conditions was noted. These results are discussed in terms of the generality of SRB across client populations and clinical settings, as well as the value of addressing contextual variables when treating stuttering.
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2/7. stuttering acquired from subcortical pathologies and its alleviation from thalamic perturbation.

    Acquired stuttering subsequent to subcortical pathology of mesothalamus was observed in four neurosurgical subjects. The patients suffered from chronic pain, seizures, and somatosensory disorders. They also exhibited unpredictable and uncontrollable speech, spasmodic blocks which were devoid of accessory features, and adaptation effect. Therapeutic mesothalamic stimulation, used as a treatment of last resort to relieve the pain and associated symptoms, also had an ameliorating effect on the stuttering. Spontaneously occurring focal abnormal EEG discharges were anatomically delineated and used as a guide for therapeutic stimulation electrode placement. Attentuation of the abnormal discharges was followed by alleviation of symptoms. This investigation examines the clinical characteristics of stuttering in four neurosurgical patients and suggests an electropathologic basis for their mesothalamic-generated speech dysfluencies. The cooccurrence of pain, seizures, somatosensory disorders, and stuttering, and their concurrent amelioration, suggests that both chronic pain and stuttering may be implicated by similar or related reticular electropathologic generators, couched in overlapping reticular networks extending from the brain stem to the thalamus, and that the acquired stuttering may be recruited as one component of a larger syndrome complex.
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keywords = pain
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3/7. Thalamic-induced stuttering (surgical observations).

    Repetitive dysfluencies of speech were elicited by mechanical perturbation of the thalamus in a patient, preparatory to therapeutic lesion placement for chronic pain. Perturbation consisted of a 2 mm advancement of a 1 mm diameter electrode in the posteroventromedial thalamus. A thalamogram revealed electropathologic discharges at the site of perturbation. These findings are of special interest anatomically because in other patients, electrical stimulation at the same site was found to alleviate stuttering (Andy, 1987; Andy, 1989; Andy & Jurko, 1985; Bhatnagar & Andy, 1989). It is suggested that dysfluencies in this patient may have resulted from an electrophysiologic disturbance of the mesothalamic component of a speech-regulating corticomesothalamic feedback circuit.
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ranking = 0.00012956456316936
keywords = pain
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4/7. Alleviation of acquired stuttering with human centremedian thalamic stimulation.

    Despite many investigations, the cerebral mechanism for stuttering remains unknown. Recently, increased attention has been paid to acquired stuttering of adult onset in the hope that the events associated with it might provide clues to the biological mechanism underlying stuttering. This attention has focused exclusively on the cortical substrates. We present our observations of acquired dysfluency, presumably of subcortical origin in a neurosurgical subject with intractable pain. The stuttering was relieved by thalamic electric stimulation. The effect of thalamic stimulation on the stuttering suggests that the pathophysiology of transient asynchronisation in the balancing and sequencing of multiple impulses is amenable to a diffusely orchestrated functional tuning of the thalamic and brainstem implicated subcortical structures and pathways.
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keywords = pain
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5/7. stuttering as a complication of strabismus surgery.

    Children may experience extremely high levels of psychological stress in the operating suite because of anxiety associated with the separation from their parents, the unfamiliar and intimidating environment, the presence of strangers in unusual attire (masks, caps, gowns), the act of being forcibly restrained, and the forceful pressing over the mouth and nose of an anesthetic mask which emits a foul-smelling gas and which seems to restrict breathing in a manner reminiscent of suffocation. High levels of anxiety can lead to regression in a child's mental development, including stuttering, which is a regression to an earlier speech pattern and failure to develop fluent speech. Two cases are reported in which children developed stuttering following inappropriate or abusive treatment by the anesthesia departments of the hospitals in which they had surgery for strabismus. Both patients were four-year-old boys.
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6/7. headache in cerebral embolic disease.

    A patient is presented who had severe headache and then developed a stuttering course of clinical neurological deficits. Arteriography demonstrated an ipsilateral proximal middle cerebral embolus. With recurrence of symptoms, repeat arteriography showed another, more proximal embolus with areas of distal occlusion. The headache probably occurred when the embolus became lodged in a pain sensitive cerebral vessel at the base of the brain. The subsequent stuttering neurological deficits were due to fragmentation of the embolus as well as recurrence.
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ranking = 0.00012956456316936
keywords = pain
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7/7. Dismantling simplified regulated breathing: a case of a bilingual stutterer.

    In this case study of a 28-year-old bilingual male, the Simplified Regulated Breathing treatment for stuttering was further dismantled. Implementing noncontingent diaphragmatic breathing in one treatment session, stuttering was reduced in both English (his second language) and Russian (his native language), while his words per minute increased. In addition, the implementation of treatment resulted in a decrease in secondary struggle behaviors associated with stuttering. The results were seen as socially valid and the treatment was seen as acceptable to the participant. Implications of this case study are presented.
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