Stuttering-like hesitation in speech during acute/post-acute phase of immune-mediated encephalitis

• Published in: Journal of fluency disorders 2018-12, Vol.58, p.70-76
• Main Authors: Dinoto, Alessandro, Busan, Pierpaolo, Formaggio, Emanuela, Bertolotti, Claudio, Menichelli, Alina, Stokelj, David, Manganotti, Paolo
• Format: Article
• Language: English
• Subjects: Acute Disease; Aged; Brain; Brain rhythms; Corticosteroids; EEG; Electroencephalography; Electroencephalography - methods; Encephalitis; Encephalitis - complications; Encephalitis - pathology; Humans; Localization; Male; Motor ability; Neural networks; Neurological disorders; Speech - physiology; Speech-language pathology; Stuttering; Stuttering - diagnosis
• ISSN: 0094-730X; 1873-801X
• DOI: 10.1016/j.jfludis.2018.09.001

•Neurogenic stuttering is evident after a dysfunction of wider neural networks.•A case of acquired stuttering after immune-mediated encephalitis is presented.•EEG characteristics of this patient have been investigated and characterized.•EEG showed a “slowed” pattern in the frontal cortex and in sensorimotor networks.•“Slowed” oscillatory activity could result in less “synchronized” motor systems. Neurogenic stuttering may be evident after a lesion/dysfunction of wider neural networks. Here we present a case of acquired stuttering as the consequence of immune-mediated encephalitis. The case of a 71-year old male who complained about the progressive onset of stuttering and disequilibrium as the consequence of immune-mediated encephalitis, is here reported. Administration of corticosteroid methylprednisolone was useful to recover from impairments. An in depth analysis of the electroencephalography (relative power of brain rhythms and source localization) during different phases of the disease/treatment was also realized. The patient showed a stuttering-like slowed speech with blocks and repetitions, especially at the beginning of words/sentences, with associated movements of the oro-facial muscles. Speech and general motor skills resulted slowed in their preparation/execution phases. Electroencephalography showed a “slowed” pattern, with delta/theta waves mainly in the prefrontal cortex and in sensorimotor networks. This case reports a probable immune-mediated encephalitis that resulted in acquired stuttering. The effect of “slowed” oscillatory brain activity on motor skills requesting sequencing and fine coordination (e.g. speech) could result in less “synchronized” systems, easily prone to disruptions.