Sudo Daisuke, Doutake Youichi, Yokota Hidenori, Watanabe Eiju
Department of General Internal Medicine, Ooshima Prefecture Hospital, Amami, Japan.
Department of Neurosurgery, Jichi Medical University, Shimotsuke, Japan.
BMJ Case Rep. 2018 May 12;2018:bcr-2017-223259. doi: 10.1136/bcr-2017-223259.
Stuttering occurs in approximately 5% of all children and 1% of adults. One type, neurogenic stuttering, is usually attributable to strokes or other structural damages to the brain areas that are responsible for language fluency. Here, we present the first case of neurogenic stuttering caused by a brain abscess. The patient was a 60-year-old man admitted for a seizure and administered an anticonvulsant, after which he began stuttering. MRI revealed a brain abscess in the left frontal lobe that extended to the dorsolateral prefrontal cortex (BA (Brodmann's area) 9 and 46), frontal eye field (BA 8) and premotor cortex and supplementary motor area (BA 6). After neurosurgical drainage and antibiotic treatment, the symptoms had resolved. This case is unique in that the therapeutic effects and localisation of the cause of stuttering were rapidly identified, allowing for a more accurate description of the neural circuitry related to stuttering.
口吃在所有儿童中发生率约为5%,在成年人中约为1%。其中一种类型,即神经性口吃,通常归因于中风或对负责语言流畅性的脑区造成的其他结构性损伤。在此,我们报告首例由脑脓肿引起的神经性口吃病例。该患者为一名60岁男性,因癫痫发作入院并接受了抗惊厥药物治疗,之后他开始口吃。磁共振成像(MRI)显示左侧额叶有一个脑脓肿,延伸至背外侧前额叶皮质(布罗德曼区(BA)9区和46区)、额叶眼区(BA 8区)以及运动前皮质和辅助运动区(BA 6区)。经过神经外科引流和抗生素治疗后,症状得以缓解。该病例的独特之处在于能够迅速确定口吃的治疗效果和病因定位,从而更准确地描述与口吃相关的神经回路。