Sugii Narushi, Matsuda Masahide, Ishikawa Eiichi
Department of Neurosurgery, University of Tsukuba, Tsukuba, JPN.
Department of Neurosurgery, University of Tsukuba Hospital, Tsukuba, JPN.
Cureus. 2024 Dec 25;16(12):e76385. doi: 10.7759/cureus.76385. eCollection 2024 Dec.
Dysprosody affects rhythm and intonation in speech, resulting in the impairment of emotional or attitude expression, and usually presents as a negative symptom resulting in a monotonous tone. We herein report a rare case of recurrent glioblastoma (GBM) with dysprosody featuring sing-song speech. A 68-year-old man, formerly left-handed, with right temporal GBM underwent gross total resection. After chemoradiation therapy, he was discharged without any deficits. Nineteen months later, the patient exhibited recurrence and presented a peculiar way of speaking with excessive melodic intonation. A head magnetic resonance imaging revealed new enhanced lesions in the residual right temporal lobe and the splenium of the corpus callosum with a massive surrounding T2-high area. The case highlights the bilateral hemispheric network underlying prosody and the compensatory failure caused by tumor progression and connectivity disruption. This first account of sing-song dysprosody in a GBM patient underscores the complexity of the language network and the need for further case accumulation to elucidate the pathophysiology of such rare presentations.
韵律障碍会影响言语的节奏和语调,导致情感或态度表达受损,通常表现为一种消极症状,致使语调单调。我们在此报告一例罕见的复发性胶质母细胞瘤(GBM)伴韵律障碍,其特征为吟诗样言语。一名68岁男性,既往左利手,患有右侧颞叶GBM,接受了肿瘤全切术。放化疗后,他出院时无任何神经功能缺损。19个月后,患者出现复发,并表现出一种奇特的说话方式,语调过度富有旋律。头部磁共振成像显示右侧颞叶残余部分及胼胝体压部有新的强化病灶,周围有大片T2高信号区。该病例突出了韵律背后的双侧半球网络以及肿瘤进展和连接中断所导致的代偿失败。这是首次报道GBM患者出现吟诗样韵律障碍,强调了语言网络的复杂性以及需要进一步积累病例以阐明此类罕见表现的病理生理学。