Apraxia of Phonation: a Case Report

발성실행증 사례연구

Apraxia of phonation (AOP) has often been described as a feature of apraxia of speech or of severe non-fluent type of aphasia. Pure AOP is rare and, to our knowledge, only two cases have been reported. Brain lesion sites of the reported cases were not those sites known to be responsible for apraxia of speech. This study presents a case of AOP which resulted from the secondary stroke in the left corona radiata immediately following the first stroke in the left temporoparietal lobe. A 61-year old right-handed man shwoed a global type of aphasia after the first cerebral infarction, but was able to generate spontaneously some short fragments of speech. On the day after the first infarction, he suffered from the secondary infarction, leaving him a complete loss of voluntary phonation. He did not showed any significant change in language functions. Several occurrences of involuntary phonation were observed upon laughing or crying. He was also able to cough unintentionally. A vidoe-stroboscopic examination failed to reveal any evidence of structural and functional impairment in larynx. Although this case is not of pure form of AOP, AOP appeared after the secondary stroke without significant changes of language impairment since the first stroke. Therefore, AOP may be a consequence of the brain lesion from the secondary stroke even though we cannot rule out the possibility of an additive effect of the secondary to the first stroke.