Riva-Posse Patricio, Busto-Marolt Laura, Schteinschnaider Angeles, Martinez-Echenique Lucia, Cammarota Angel, Merello Marcelo
Neuroscience Department, Movement Disorders Section, Raúl Carrea Institute for Neurological Research, FLENI, Montañeses 2325, 1428AQK, Ciudad de Buenos Aires, Argentina.
Parkinsonism Relat Disord. 2008;14(5):415-9. doi: 10.1016/j.parkreldis.2007.11.006. Epub 2008 Mar 7.
Stuttering is often accompanied by involuntary movements, abnormal gestures or changes in facial expression.
To describe the incidence and phenomenology of abnormal movements (AMs) in stuttering patients.
Eighty-five consecutive patients with stuttering and 119 normal controls videotaped and subsequently reviewed, in which AMs were classified as voluntary or involuntary, and as concurrent or unrelated to speech. Movement phenomenology was correlated with disease severity.
Of 85 stuttering patients studied, 51.7% had AMs and 22 more than one AM. Sixty-six different AMs were identified, of which 83.3% occurred during speech, 72.7% were classified as involuntary, and 27.2% as voluntary. Of 38 involuntary movements concurrent to speech, 25 were originally perceived as voluntary, but had since become involuntary through repeated use during stuttering. All involuntary movements not concurrent to speech fulfilled criteria for tics.
AMs occurring during stuttering were not always involuntary; movements not concurrent with speech clearly fulfilled clinical criteria for tics and were similar in incidence to normal controls. Inverse correlation was found between conscious control of movement during speech and stuttering severity. Many involuntary movements occurring during speech were clearly referred by patients as initially voluntary early on in the development of their speech disorder (starters or unblockers), underlining the importance of repetitive use of complex motor sequences as a source for putative involuntary movement genesis.
口吃常伴有不自主运动、异常手势或面部表情变化。
描述口吃患者异常运动（AMs）的发生率和现象学特征。
对85例连续的口吃患者和119名正常对照者进行录像并随后进行回顾，其中AMs被分类为自主或不自主，以及与言语同时发生或无关。运动现象学与疾病严重程度相关。
在研究的85例口吃患者中，51.7%有AMs，22例有不止一种AMs。共识别出66种不同的AMs，其中83.3%发生在言语过程中，72.7%被分类为不自主，27.2%为自主。在与言语同时发生的38种不自主运动中，25种最初被认为是自主的，但在口吃过程中通过反复使用已变为不自主。所有与言语不同时发生的不自主运动均符合抽动标准。
口吃时出现的AMs并不总是不自主的；与言语不同时发生的运动明显符合抽动的临床标准，且发生率与正常对照相似。发现言语过程中运动意识控制与口吃严重程度呈负相关。许多言语过程中出现的不自主运动患者明确表示在言语障碍发展早期最初是自主的（起始动作或解除阻塞动作），强调了重复使用复杂运动序列作为潜在不自主运动发生源的重要性。
