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P Auzou

Publications and source records attributed to P Auzou.

At least 19 recordsLinked to original sources

The place of perceptual analysis of dysarthria in the differential diagnosis of corticobasal degeneration and Parkinson's disease.

OBJECTIVE: To characterize the dysarthria in patients with corticobasal degeneration (CBD) and determine if analysis of speech in isolation helps to distinguish CBD patients from patients with Parkinson's disease (PD). METHODS: 60 subjects were assessed by means of perceptual analysis of speech: 15 patients with CBD, 15 patients with PD and 30 control subjects. A detailed profile was furnished with the help of 33 perceptual items. A global perceptual approach was used to classify patients by judges blind to the medical diagnosis. Rating scales were adapted to quantify the degree of spasticity and hypokinesia in the speech of each patient. RESULTS: Dysarthria was frequent in CBD even though it remained mild for a long period of time. Group analysis revealed the importance of temporal errors of speech control in CBD patients while voice disturbances were most frequent in PD patients. However, attempts to classify patients according to global perceptual analysis remained below a reasonable level of clinical acceptability. Finally, even though the widespread neuropathological changes suggest that deviant speech dimensions of several types of dysarthria might be found in CBD, evidence for a mixed dysarthria with presence of spastic elements could not be established. CONCLUSION: The findings support the view that even though perceptual analysis is mandatory in the management of dysarthric patients, it does not help in the clinical differential diagnosis of CBD.

Aged↗

[Speech therapy for the dysarthria of Parkinson's disease].

INTRODUCTION: Dysarthria is frequent in Parkinson's disease and impairs communication. STATE OF THE ART: Use of levodopa or surgical procedures does not significantly improve speech. Traditional speech therapy can lead to improvement of dysarthria, and intensive programs have recently showed substantial beneficial effects on parkinsonian dysarthria. PERSPECTIVES: More work is needed to evaluate speech treatment efficacy. CONCLUSION: Earlier and more frequent speech therapy in parkinsonian dysarthria patients may contribute to better quality of life.

Dysarthria↗

[Dysarthria?].

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Botulinum Toxins, Type A↗

[Perceptual analysis of dysarthria: presentation and validation of a clinical scale. Preliminary study].

Perceptual analysis is widely used in clinical practice to assess motor speech disorders such as dysarthria. Unfortunately, there is no standardised tool available in French. The purpose of this study was first to develop a perceptual rating system modelled after systems currently used in the English literature and second to determine its reliability. We evaluated 33 dimensions using a 5-point scale. The production of 10 dysarthric patients were rated by 9 clinicians during both spontaneous speech and a reading task. Intra judge reliability (at 1-point) was about 90 percent, while inter judge reliability was about 80 percent. Ratings were comparable for the spontaneous speech and the reading task. Perceptual analysis of dysarthria is an easy and reproducible approach that can be used for the initial evaluation and for the follow up of dysarthric patients.

Adult↗

Dysarthria and orofacial apraxia in corticobasal degeneration.

The authors evaluated dysarthria and orofacial apraxia (OFA) in 10 patients with a clinical diagnosis of corticobasal degeneration (CBD). Nine patients were slightly dysarthric according to the French version of the Frenchay Dysarthria Assessment, which evaluates the motricity of the components of the vocal tract. The severity of dysarthria assessed by an intelligibility score was correlated to the global severity of the disease, but not to the duration of the disease. Voluntary movements of the tongue and the lips were impaired in all patients. OFA, evaluated with simple and sequential gestures, was present in nine patients. Sequential gestures were more frequently impaired. The score of OFA was not correlated to the severity of dysarthria, suggesting independent underlying mechanisms. Thus, when specifically assessed, dysarthria and OFA are more frequent in CBD than usually reported. We propose that the underlying pathophysiology is the result of a deficit in programming and execution of repetitive movements.

Aged↗

[Evaluation of motor speech function in the diagnosis of various forms of dysarthria].

Perceptual analysis is not sufficient enough to identify specific dysarthria types. In order to improve the discrimination between dysarthria types, we developed a standardized evaluation of different functions controlling speech motor performances. This was applied to 90 patients suffering from hypokinetic, spastic or ataxic dysarthria and 15 control subjects. A discriminate analysis showed that 71.4 p. 100 of the cases were correctly classified. This model was validated within a new group of 21 patients and showed that the less severe dysarthric parkinsonian patients were difficult to distinguish from control subjects. The discriminate analysis was then used for 20 patients with atypical parkinsonism. Seven patients with progressive supranuclear palsy were considered to have hypokinetic dysarthria. The 6 patients with multisystem atrophy and 7 with corticobasal degeneration were classified among the 3 dysarthric types. We suggest that motor speech evaluation may contribute to differential diagnosis within groups of patients suffering from atypical parkinsonism.

Aged↗

[Isolated truncular paralysis of the musculocutaneous nerve of the upper limb].

Isolated palsy of the musculocutaneous nerve, terminal branch of the lateral cord of the brachial plexus, is rare. It is responsible for sensory loss of the distal forearm and weakness of elbow flexion. It occurs after shoulder or clavicle surgery, trauma (fracture, dislocation, blows on the shoulder), violent exercice or extension of the forearm, prolonged positioning of the shoulder in extension-abduction-external rotation and phlebotomy. Different mechanisms such as stretching, compression or direct nerve injury are encountered. We report 5 cases with isolated musculocutaneous nerve palsy, including bilateral palsy caused by violent forearm extension. In other cases, mechanisms were an extensive stretching during surgery and compression caused by prolonged supine position. Different injury locations and causes described in literature are reviewed.

Accidents, Traffic↗

[Cortico-basal degeneration].

Cortico-basal degeneration (CBD) has recently emerged as a distinctive entity of the Parkinson-plus syndromes but presents with great clinical and anatomopathological heterogeneity. The purpose of this review is to increase awareness of the syndrome and facilitate its recognition in both typical and unusual cases. We will herein review the 398 cases found in the English and French literature with their clinical, laboratory and pathological features.

Aged↗

[Clinical assessment of dysarthria: presentation and validation of a method].

We adapted in French the Frenchay Dysarthria Assessment (FDA) developed by P. Enderby in 1983. This tool quantitatively evaluates the organs involved in speech and provides a measurement of intelligibility. Productions of normal subjects were analyzed. Reproductibility of data (correlation and interobserver concordance) was high in 18 dysarthric patients. A study performed in 100 dysarthric patients corresponding to 4 types of dysarthria (spastic, ataxic, hypokinetic and mixte) showed that dysarthria resulted from a global impairment of organs implied in speech, rather than one specific organ. The reduction in the intelligibility score was related to organ impairment.

Aged↗

[Naming impairment for man-made objects in a case of herpes encephalitis].

We report the naming performances of a 25 year-old woman with a left internal and inferior temporal lesion caused by herpes encephalitis who showed a preferential impairment for naming man-made objects. Evidence for category-specific effect was provided by a stepwise logistic regression using 171 pictures characterized by several parameters (words frequency, diversity of responses, length, name agreement, majoritary response, familiarity, visual complexity and canonicity). Analyses were realized over a 5 month period. Methodological considerations, anatomic correlations and arguments suggesting lexical access or semantic storage disturbance are discussed.

Adult↗

[Cerebrovascular complication in non-bacterial thrombotic endocarditis. Value of cardiac transesophageal ultrasonography].

BACKGROUND: Non-bacterial thrombotic endocarditis in patients with cancer can lead to ischemic stroke. Endocardial vegetations are usually small and may be missed at transthoracic echocardiography. CASE REPORT: Disseminated intravascular coagulation developed in a woman with ischemic stroke. Transthoracic echocardiography was normal. Four days later, transesophageal echocardiography revealed a large mitral vegetation suggesting non-bacterial thrombotic endocarditis. The diagnosis was confirmed at pathology which reported carcinoma of the colon. DISCUSSION: Transthoracic echocardiography is rarely contributed to the diagnosis of thrombotic endocarditis. In our patient transesophageal echocardiography grave the diagnosis before death instead of retrospectively at autopsy as usually occurs, demonstrating the value of transesophageal echocardiography for cancer patients who develop ischemic stroke.

Adenocarcinoma↗

[Spontaneous thrombosis of cerebral arteriovenous malformation].

Complete disappearance of a cerebral arteriovenous malformation (AVM), 9 years after its discovery, is reported in a 45-year-old man. This unusual evolution was revealed by the onset of 3 seizures. CT scan and MR imaging eliminated any hemorrhage and carotid angiography showed the spontaneous thrombosis of the whole malformation. The evolution of the MRI signals demonstrates that seizures and the disappearance of the AVM were concomitant. It is suggested that the spontaneous thrombosis of the venous drainage caused the AVM disappearance with cerebral oedema responsible of seizures.

Epilepsy, Generalized↗

[EEG recordings during episodes of palinacousis and palinopsia].

Palinopsia (visual perseveration) and palinacousis (auditory perseveration) are reported in a 51-year-old woman with a left temporo parietal astrocytoma. EEG showed a left temporal delta-focus with sharp waves. EEG was not modified during neither palinacousis nor palinopsia. The relationship between the two hallucinatory phenomena and epilepsy is discussed.

Brain Neoplasms↗