Dysfluency (Stuttering) in Extrapyramidal Disease

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Abstract
• Acquired stuttering in the adult is rare and is usually associated with trauma or vascular disease. A recent patient had adult-onset dysfluency, and, subsequently, signs of progressive supranuclear palsy developed. A review of cases of extrapyramidal disease identified five parkinsonian patients with stutteringlike behavior. Dysfluencies were of slow onset and were an early symptom. Speech was characterized by repetitions/prolongations on initial syllables, which occurred on both small grammatical and substantive words. Dysfluency was found mostly in self-formulated speech. There was a positive adaptation effect. No secondary motor symptoms occurred and behavioral response to dysfluency was minimal. Speech characteristics of dysfluency associated with extrapyramidal disease differ from both developmental dysfluency and acquired dysfluency secondary to vascular or traumatic insults. In patients with adult-onset stutteringlike dysfluencies it is important to consider extrapyramidal disease.

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