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7 results

  • Comparison of long-term speech and impedance outcome of cochlear implantation in prelingual deaf paediatric patients between cochleostomy and round window insertion

  • Nidhin Das K., Vidhu Sharma, Vishudh Mohan, Kapil Soni, Amit Goyal
  • Journal:
    The Journal of Laryngology & Otology , First View
    Published online by Cambridge University Press:
    25 October 2024, pp. 1-8
    • Article
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  • Objectives

    To compare long-term impedance and functional outcomes between the round window and cochleostomy approaches in cochlear implantation patients.

    Methods

    Ninety prelingually deafened children who underwent unilateral cochlear implantation participated in this prospective observational study. Participants were divided into round window and cochleostomy groups. Impedance and speech perception were assessed at switch-on, and at 6, 12, and 24 months.

    Results

    Impedance was similar between groups except at switch-on, where the cochleostomy group had higher basal turn impedance (2.41 vs 1.32 kΩ). At 24 months, speech outcomes were as follows: word recognition in quiet (round window 96.2 per cent, cochleostomy 95.3 per cent), word recognition in noise (round window 88.8 per cent, cochleostomy 87.4 per cent), sentence recognition (round window 78.2 per cent, cochleostomy 77.3 per cent), and vowel recognition (round window 91.2 per cent, cochleostomy 90.1 per cent).

    Conclusion

    No significant differences in impedance or speech outcomes were found between the round window and cochleostomy groups, except for higher basal-turn impedance at switch-on in the cochleostomy group, indicating more fibrosis.

  • 4 - Disorders of Thought and Speech

  • Patricia Casey, University College Dublin, Brendan Kelly, Trinity College, Dublin
  • Book:
    Fish's Clinical Psychopathology
    Published online:
    12 January 2024
    Print publication:
    01 February 2024, pp 42-62

  • Summary

    Disorders of thought include disorders of intelligence, disorders of the stream of thought, disorders of thought possession and obsessions, and disorders of the content and form of thinking. This chapter outlines disorders of intelligence, disorders of thinking, disorders of thought tempo, disorders of the continuity of thinking and disorders of the content of thinking. It presents descriptions of obsessions and primary and secondary delusions, as well as detailed examinations of specific delusions of persecution, infidelity, love, grandiosity, ill-health, guilt, nihilism and poverty. Speech disorders are also explored, along with aphasias. The chapter concludes with suggested questions for eliciting specific symptoms in clinical practice, in addition to standard history-taking and mental state examination. Disorders of thought and speech are central to the manifestation and diagnosis of many psychiatric disorders, including schizophrenia, and this chapter provides both descriptions and explanations of key signs and symptoms in this field.

  • Bilateral striopallidodentate calcinosis presenting with psychiatric symptoms and speech disorders

  • Betul Ozdilek, Kayıhan Uluc, Dilek I. Gunal
  • Journal:
    Acta Neuropsychiatrica / Volume 24 / Issue 5 / October 2012
    Published online by Cambridge University Press:
    24 June 2014, pp. 310-313

  • Ozdilek B, Uluc K, Gunal DI. Bilateral striopallidodentate calcinosis presenting with psychiatric symptoms and speech disorders.

    Background: Bilateral striopallidodentate calcinosis (BSPDC), also known as Fahr's disease, is a rare neurodegenerative disorder characterised by the deposition of calcium and other minerals in the basal ganglia, centrum semiovale and cerebellum. It is usually idiopathic. Its clinical manifestations vary from asymptomatic individuals to neuropsychiatric abnormalities, movement disorders, cerebellar symptoms and cognitive impairments.

    Methods: Five cases of BSPDC – all of which include psychiatric symptoms and speech problems – from two families are documented in this article.

    Conclusion: The most important diagnostic marker is the demonstration of symmetrical intracranial calcifications. Computerised tomography of the brain is the most frequently used radiologic method to diagnose BSPDC.

  • Functional Maturity of Brain Structures in Children Aged 7-8 with Differing Levels of Speech Development

  • Lyudmila V. Sokolova, Tatyana V. Yemelianova
  • Journal:
    The Spanish Journal of Psychology / Volume 14 / Issue 1 / May 2011
    Published online by Cambridge University Press:
    10 January 2013, pp. 509-518

  • First graders (aged 7-8) in a public elementary school served as subjects for this study. The structural components of their speech were analyzed to determine speech maturity level; total EEG activity was analyzed to assess the functional maturity of brain structures. Results showed that children with levels of speech below the age norm exhibited abnormal EEG patterns suggesting immaturity of the cerebral cortex and fronto-thalamic regulatory system, as well as impairments in the functioning of the mesodiencephalic structures and nonspecific activation systems. Abnormalities in the functioning of brain regulatory systems and the presence of local abnormalities in EEG activity of deep origin are important factors in determining the severity of functional speech impairments.

  • 33 - Management of insomnia in the elderly: the efficacy and safety of non-benzodiazepine hypnotics

  • from Part 4 - Treatment of sleep disorders in the elderly
  • Edited by S. R. Pandi-Perumal, Jaime M. Monti, Universidad de la República, Uruguay, Andrew A. Monjan, National Institute on Aging, Bethesda, Maryland
  • Book:
    Principles and Practice of Geriatric Sleep Medicine
    Published online:
    04 August 2010
    Print publication:
    26 November 2009, pp 344-361

  • Summary

    This chapter summarizes the recent knowledge on diagnosis, etiology, and treatment of restless legs syndrome (RLS) in the elderly. In the elderly, the ability to express experienced bodily sensations verbally may be limited by the impact of co-morbid conditions such as cognitive impairment, speech disorders, or aphasic syndromes. A potential central role of iron pathology for the pathophysiology of RLS is indicated primarily by secondary forms of the disorder, i.e. iron deficiency, end-stage renal disease, and pregnancy. The dopamine precursor levodopa in combination with a dopa-decarboxylase inhibitor is an effective therapeutic agent with high tolerability and without serious side effects, also in patients with concomitant medical disorders. The most clinically relevant problem with dopaminergic drugs in treating RLS is the development of augmentation, a medication use-related increase of symptoms, which usually occurs after an initial improvement. In severe cases, augmentation demands a switch of medication.

  • Anterior fracture dislocation of the odontoid peg in ankylosing spondylitis as a cause for rhinolalia clausa: a case study

  • J M Hilton, P Tassone, J Hanif, B Blagnys
  • Journal:
    The Journal of Laryngology & Otology / Volume 122 / Issue 1 / January 2008
    Published online by Cambridge University Press:
    30 April 2007, pp. 105-107
    Print publication:
    January 2008

  • We present an unusual cause of rhinolalia clausa secondary to an oropharyngeal mass. A 69-year-old male presented to the otorhinolaryngology clinic with a one year history of a ‘plummy’ voice. He had a longstanding history of severe ankylosing spondylitis. Examination revealed an obvious hyponasal voice and a smooth hard mass in the midline of the posterior nasopharyngeal and oropharyngeal walls. Subsequent computed tomography scans and lateral plain neck X-ray showed a fracture dislocation of the odontoid peg, secondary to ankylosing spondylitis, which had eroded through the body of the C1 vertebra to lie anteriorly, resulting in the aforementioned impression into the pharyngeal mucosa. The radiological images, the role of the nasal airways in phonation and the causes of hyponasal speech are discussed.

  • 36 - Neurorehabilitation of the stroke survivor

  • from Section C - Disease-specific neurorehabilitation systems
  • Edited by Michael Selzer, University of Pennsylvania, Stephanie Clarke, Université de Lausanne, Switzerland, Leonardo Cohen, National Institute of Mental Health, Bethesda, Maryland, Pamela Duncan, University of Florida, Fred Gage, Salk Institute for Biological Studies, San Diego
  • Book:
    Textbook of Neural Repair and Rehabilitation
    Published online:
    04 August 2010
    Print publication:
    16 February 2006, pp 579-592

  • Summary

    Comprehensive rehabilitation improves the functional abilities of the stroke survivor, despite age and neurologic deficit, and decreases long-term patient care costs. Motor recovery usually occurs in well-described patterns after stroke. A number of methods are currently used to facilitate movement in affected extremities and teach compensatory techniques to perform activities of daily living (ADL). Stroke survivors usually do not place the same degree of importance on improving upper extremity performance as that of the lower extremity. Complications involving the upper extremity may prevent the stroke survivor from reaching patient's maximal potential. Speech and language disorders may be diagnosed by both formal testing and conversational interaction. Impaired content of speech suggests aphasia or cognitive-communication impairment. Good communication between the neurorehabilitation physician, the patient, and the family will facilitate optimal care, and provide the patient with the opportunity to reach his maximal functional potential.