We report two patients, in whom stuttering evolved as an adverse effect of pallidal deep brain stimulation for treating dystonia. Speech dysfluency was observed under conditions that optimally suppressed dystonic symptoms without inducing other extrinsic stimulation effects. This emphasizes a role of the sensorimotor part of the internal globus pallidus in regulating speech fluency.
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Viedo Case 1 Segment 1 demonstrates the fluency of spontaneous speech and reading in the presence of severe torsion dystonia in patient 1 before surgery. Segment 2 presents severe stuttering during the interview with a speech therapist three years after initiating pallidal neurostimulation. Segment 3 Stuttering is not improved during a period of unilateral pallidal stimulation after fracture of the right extension cable, while contralateral dystonia worsened acutely. Video Case 2 Segment 4 presents the fluency of reading before surgery in patient 2 Segment 5 demonstrates the presence of marked stuttering one year after surgery during the interview with a speech therapist, while cervical dystonia is almost completely suppressed. (MPG 12108 kb)
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Nebel, A., Reese, R., Deuschl, G. et al. Acquired stuttering after pallidal deep brain stimulation for dystonia. J Neural Transm 116, 167–169 (2009). https://doi.org/10.1007/s00702-008-0173-x
- Internal globus pallidus
- Deep brain stimulation