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From: marie-claude monfrais-pfauwadel
Date: 10/7/03
Time: 4:31:57 PM
Remote Name: 194.158.98.37
Beside the medical stuttering clinic, the speech lab in the Georges Pompidou hospital takes care of MS patients, lateral amyotrophic patients, closed head injuries, locked-in syndroms etc...My colleague (Dr Crevier-Buchman) and I are used to diagnose and take care of all kinds of neurological diseases that may impair speech and/ or swallowing. Among the cases I present via this conference, non or almost none are "degenerative" or progressive diseases, except the Wilson's disease if it is not diagnosed and taken care of - but the cerebellar ataxia of the youngest sister I present may be a "progressive" disorder - her case has worsened till we made the correct diagnosis.... In the addendum I copied a part of my dissertation (in phonetic sciences) about the nosological classification of disfluencies, going (phonetically) from the "smoothest" kind ( whole syllable) to the most typical (stuttering), which is the only speech disorder where the syllable is blown up and the syllable nucleus separated from the attack. It is why I consider that the parkinson palilia IS NOT a stutter : the syllable stays intact, there is no lack of rythm and the tonicity is weakening...
Those are cases that caught my attention because they show us that a medical examination needs to be exhaustive, because we have to be cautious about our labelling of disfluencies, because a thorough examination must includes what happens to the patients also when they do not speak (dystonias may occur outside of communication attempts...)
I am giving no answers...just asking you and you and you (thanks Judith) questions ! Listen, observe, analyze before labelling...
MC Monfrais-Pfauwadel