Speech apraxia

Dementia is the loss of function in multiple cognitive domains that occurs over a longer period of time, usually months to years. Diagnostic features include memory impairment and at least one of the following aphasia (deterioration of speech), apraxia (impaired ability to execute motor activities despite intact motor abilities, sensory function, and comprehension of the required task), agnosia (failure to recognize or identify objects despite intact sensory function), or disturbances in executive functioning.1... 

Slow, relatively low exposure accumulation of Al over a period of years can lead to a number of clinical manifestations, some of which seem to be bypassed in acute Al encephalopathy due to extremely high exposure to Al. Al encephalopathy is a clinical syndrome and, as can be seen in Table 5, there are similarities and differences in the neurological symptoms of acute and chronic Al encephalopathy. In chronic Al encephalopathy microcytic anemia [41, 93, 95—98] and EEG changes [99-104] can precede clinical symptoms [105]. It is unknown if these symptoms can also precede the clinical symptoms of acute encephalopathy. In contrast to acute Al encephalopathy, where speech disturbances are absent, speech disorders are an important presenting clinical sign of neurotoxicity in chronic Al encephalopathy. The neurological basis of the speech apraxia is obscure but it appears to have elements of dysarthria and dysphasia [33, 73], The initial... 

Speech therapy There is insufficient evidence to support or refute possible benefits of speech therapy after stroke for either aphasia (Greener et al. 2002) or speech apraxia (West et al. 2005), although patients and carers value such input and stroke-care guidelines recommend speech therapy. Speech therapists also have a role in the management of dysarthria and swallowing. 

Alzheimer s disease (AD) is the most common neurodegenerative disease in the elderly. Prevalence increases with age and by the year 2050 it has been estimated that world-wide 1 out of 85 persons will suffer from AD (Brookmeyer et ah, 2007). AD is clinically characterized by progressive memory deficits, speech problems, and visuospatial orientation. As the disease advances, the patient my develop apraxia (loss of the ability to execute or cany out learned purposeful movements), and requires help in performing activities of daily living. In moderate and severe stages of the disease, AD patients may show signs of neuropsychiatric syndromes like labile affect, aggression, hallucinations, sleep disturbances, and apathy. 

Interventions for apraxia of speech following stroke. Cochrane Database of Systematic Reviews 4 CD004298... 

When neurological symptoms occur in patients taking tacrolimus they are very similar to those seen in patients taking ciclosporin, with more frequent insomnia, tremor, and headaches, but a similar rate of severe neurological adverse effects, such as acute psychosis, peripheral neuropathy, seizures, encephalopathy, coma, and paralysis. Persistent speech disorders (dysarthria, apraxia, expressive aphasia, akinetic mutism), and visual blurring can also occur (SEDA-21, 391) (SEDA-22, 420) (24). 

A 48-year-old man developed acute loss of speech and swallowing apraxia shortly after hver transplantation. Tacrolimus serum concentrations were very high. Although there was progressive improvement after tacrolimus withdrawal, residual speech deficits were still present 3 weeks later. A PET scan showed a marked reduction in metabolic rate in the temporal lobes and the adjacent parieto-occipital region bilaterally. 

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