Case Report

Speech Rehabilitation in Wilson’s Disease: A Case Study

Abstract

Wilson’s disease is a rare hereditary disorder passed down in the autosomal recessive way. This disorder involves the speech parts of the brain leading to dysarthria, which impairs all of the five speech systems, i.e. the respiratory, phonation, articulation, resonance, and prosody. The patient studied in this research was a 28-year-old woman with Wilson’s disease, who visited Rofaydeh Rehabilitation Hospital in Tehran City with complaints about severe speech disorders. Based on the clinical and paraclinical examinations the patient was diagnosed with a decrease in the maximum phonation time (MPT) of 2 to 3 seconds, reduced intelligibility and articulation impairment. The patient underwent medicinal, behavioral, and rehabilitation (include speech therapy) treatments. Following a continuous two-year follow-up rehabilitation, a considerable improvement in the speech was observed as an increase in intelligibility (up to 5% of the words), the consistency between respiration and speech and an increase in verbal and nonverbal communications.

Merle U, Schaefer M, Ferenci P, Stremmel W. Clinical presentation, diagnosis and long-term outcome of Wilson’s disease: a cohort study. Gut. 2007;56(1):115-20.

Coffey AJ, Durkie M, Hague S, McLay K, Emmerson J, Lo C, et al. A genetic study of Wilson’s disease in the United Kingdom. Brain. 2013;136(5):1476-87.

Grover S, Gupta P, Kumar A, Mahajan H. Extensive gray & white matter abnormalities in Wilson's disease: a case report. Indian Journal of Radiology and Imaging. 2006;16(1):91.

Ono S, Kurisaki H. An unusual neurological disorder with abnormal copper metabolism. Journal of neurology. 1988;235(7):397-9.

Poujois A, Pernon M, Trocello J-M, Woimant F. Dystonic dysarthria in Wilson disease: efficacy of zolpidem. Frontiers in neurology. 2017;8.

Kuwert T, Hefter H, Scholz D, Milz M, Weiss P, Arendt G, et al. Regional cerebral glucose consumption measured by positron emission tomography in patients with Wilson's disease. European journal of nuclear medicine. 1992;19(2):96-101.

Volkmann J, Hefter H, Lange H, Freund H-J. Impairment of temporal organization of speech in basal ganglia diseases. Brain and language. 1992;43(3):386-99.

Gulyas AE, Salazar-Grueso EF. Pharyngeal dysmotility in a patient with Wilson’s disease. Dysphagia. 1988;2(4):230-4.

Pernon M, Trocello J, Vaissière J, Cousin C, Chevaillier G, Rémy P, et al. Could speech rate of Wilson's disease dysarthric patient be improved in dual task condition? Revue neurologique. 2013;169(6-7):502-9.

van Dongen HR, Catsman-Berrevoets CE, van Mourik M. The syndrome of'cerebellar'mutism and subsequent dysarthria. Neurology. 1994;44(11):2040-.

Pešák J, Opavský J. Decreased copper level in the blood serum of male stutterers and the occurrence of the vibratio brevis phenomenon. Biomedical Papers. 2000;144(143):71-4.

Koidis P, Topouzelis N. Palatal lift prosthesis for palatopharyngeal closure in Wilson's disease. Orthodontics & craniofacial research. 2003;6(2):101-3.

Hefter H, Arendt G, Stremmel W, Freund HJ. Motor impairment in Wilson's disease, II: slowness of speech. Acta neurologica scandinavica. 1993;87(2):148-60.

Day LS, Parnell MM. Ten-year study of a Wilson's disease dysarthric. Journal of communication disorders. 1987;20(3):207-18.

Lihite RJ, Choudhury U, Surender G, Pal B, Lahkar M. An Early Sign of Wilson’s Disease: Dysarthria. Journal of clinical and diagnostic research: JCDR. 2014;8(3):188.

Yorkston KM, Strand EA, Kennedy MR. Comprehensibility of dysarthric speech: Implications for assessment and treatment planning. American Journal of Speech-Language Pathology. 1996;5(1):55-66.

Weismer G, Martin R, Kent R. Acoustic and perceptual approaches to the study of intelligibility. Intelligibility in speech disorders. 1992:67-118.

Magalhaes A, Caramelli P, Menezes J, Lo L, Bacheschi L, Barbosa E, et al. Wilson's disease: MRI with clinical correlation. Neuroradiology. 1994;36(2):97-100.

Lorincz MT. Neurologic Wilson's disease. Annals of the New York Academy of Sciences. 2010;1184(1):173-87.

Sidiropoulos C, Hutchison W, Mestre T, Moro E, Prescott IA, Mizrachi AV, et al. Bilateral pallidal stimulation for Wilson's disease. Movement Disorders. 2013;28(9):1292-5.

Nilipour R, Pourshahbaz A, Ghoreyshi ZS. Reliability and validity of bedside version of Persian WAB (P-WAB-1). Basic and clinical neuroscience. 2014;5(4):253.

Berry WR, Darley FL, Aronson AE, Goldstein NP. Dysarthria in Wilson’s disease. Journal of Speech, Language, and Hearing Research. 1974;17(2):169-83.

De Bodt MS, Huici MEH-Da, Van De Heyning PH. Intelligibility as a linear combination of dimensions in dysarthric speech. Journal of communication disorders. 2002;35(3):283-92.

Icht M, Ben-David BM. Oral-diadochokinesis rates across languages: English and Hebrew norms. Journal of Communication Disorders. 2014;48:27-37.

Tagawa A, Ono S, Shibata M, Imai T, Suzuki M, Shimizu N. A new neurological entity manifesting as involuntary movements and dysarthria with possible abnormal copper metabolism. Journal of Neurology, Neurosurgery & Psychiatry. 2001;71(6):780-3.

Cahalin LP, Braga M, Matsuo Y, Hernandez ED. Efficacy of diaphragmatic breathing in persons with chronic obstructive pulmonary disease: a review of the literature. Journal of Cardiopulmonary Rehabilitation and Prevention. 2002;22(1):7-21.

Albert ML, Sparks RW, Helm NA. Melodic intonation therapy for aphasia. Archives of neurology. 1973;29(2):130-1.

Namura M, Motoyoshi M, Namura Y, Shimizu N. The effects of PNF training on the facial profile. Journal of oral science. 2008;50(1):45-51.

Files
IssueVol 3 No 2 (2018): Spring QRcode
SectionCase Report(s)
Keywords
Wilson’s Disease Adult Abnormal Metabolism Speech Therapy Rehabilitation

Rights and permissions
Creative Commons License This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
How to Cite
1.
Farazi M, Amrevani M, Ilkhani Z, Amirzargar N. Speech Rehabilitation in Wilson’s Disease: A Case Study. CRCP. 2018;3(2):44-49.