Dear All,

This is a clinical question directed to those working
with adults with neurological disorders. I am
currently working with a 75 year old lady with a
diagnosis from the consultant neurologist of "cortical
dysarthria", a term which I have not come across
before. She has a history of TIAs but was never
admitted to hospital and has no limb weakness or
visual field deficit, her speech is the only area
impaired. She presents with very slow, non fluent
speech with unusual prosody - not a monotone but
prosody is definitely reduced. She has no slurring of
speech and no muscle weakness, so her articulation is
good. She has no difficulty with most language
assessments, although she sometimes comments that
words are hard to find. She does have difficulty with
some phonological awareness tasks such as rhyme
judgment and syllable segmentation. She has no
cognitive difficulties. An MRI scan showed several
hyperintense foci in the white matter of both cerebral
hemispheres, with one larger focus near the left
putamen and anterior internal capsule.

I am writing to find out whether anyone has come
across a similar patient, or anyone who has come
across the term cortical dysarthria before, or anyone
who has any ideas of what therapy techniques to try.
So far in therapy I have been working on phonological
awareness and prosody, mainly through reading aloud
tasks. She has not made much progress.

Thankyou very much for any suggestions,

Heather Rae
City Hospitals Sunderland

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