Kreisler Alexandre, Verpraet Anne-Caroline, Veit Solène, Pennel-Ployart Odile, Béhal Hélène, Duhamel Alain, Destée Alain
Lille University Medical Center, FranceInstitut National de la Santé et de la Recherche Médicale (INSERM) Unité Mixte de Recherche (UMR) 1172, Lille, France.
Lille University Medical Center, France.
J Speech Lang Hear Res. 2016 Oct 1;59(5):940-949. doi: 10.1044/2016_JSLHR-S-15-0169.
To better define the clinical characteristics of idiopathic oromandibular dystonia, we studied voice, speech, and swallowing disorders and their impact on activities of daily living.
Fourteen consecutive patients with idiopathic oromandibular dystonia and 14 matched, healthy control subjects were included in the study.
Dysarthria was the most common disorder and its characteristics varied from one patient to another. However, we frequently observed a hyperkinetic, dysarthric profile characterized by imprecise consonants, a rough voice, changes in intensity, and hypernasality. Dysphagia appeared to be slightly less frequent and less disabling than dysarthria. Most patients had difficulty swallowing solids, and the oral phase was particularly problematic. Dysarthria and dysphagia affected activities of daily living in general and the psychological/emotional domain in particular.
The characteristics of dysarthria in oromandibular dystonia vary significantly from one patient to another due to differences in the set of affected muscles, so each patient should receive a personalized rehabilitation program. Dysarthria was the most prominent symptom, although spasmodic dysphonia was more frequent than expected. Further laboratory-based studies are needed to clarify the mechanisms and consequences of dysphagia in oromandibular dystonia.
为了更好地明确特发性口下颌肌张力障碍的临床特征，我们研究了嗓音、言语及吞咽障碍及其对日常生活活动的影响。
本研究纳入了14例连续的特发性口下颌肌张力障碍患者以及14例匹配的健康对照者。
构音障碍是最常见的障碍，其特征在不同患者之间存在差异。然而，我们经常观察到一种运动过多性构音障碍的表现，其特点为辅音发音不准确、嗓音粗糙、强度改变及鼻音过重。吞咽困难的出现频率似乎略低于构音障碍，且致残性也较低。大多数患者在吞咽固体食物时存在困难，口腔期尤其成问题。构音障碍和吞咽困难总体上影响日常生活活动，尤其在心理/情感领域。
由于受累肌肉组合的差异，口下颌肌张力障碍中构音障碍的特征在不同患者之间有显著差异，因此每位患者都应接受个性化的康复计划。构音障碍是最突出的症状，尽管痉挛性发音困难比预期的更常见。需要进一步开展基于实验室的研究，以阐明口下颌肌张力障碍中吞咽困难的机制及后果。
