片麻痺を伴った脳卒中後遺症例に対する聴覚•言語機能検査の診断的意義

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Speech and auditory function tests were performed on 96 apoplectic patients with hemi-plegia, and the relationship between these results and cerebral lesions were studied. The patients were classified as follows: 1) Right hemiplegia without speech disorders (18 cases). 2) Left hemiplegia without speech disorders (22 cases). 3) Right hemiplegia with dysarthria (12 cases). 4) Left hemiplegia with dysarthria (8 cases). 5) Right hemiplegia with aphasia (16 cases). 6) Right hemiplegia with dysarthria and aphasia (20 cases). Speech function tests consisted of articulation test and articulatory organ movement test. Auditory function tests included the routine pure tone test and special tests, which consisted of directional hearing test, non-distorted and distorted speech tests, binaural integration test and interaural differentiation test. The results were as follows: 1) Articulatory dysfunctions a) The tongue tended to deviate to the side of hemiplegia, while the velum was deviated to the opposite side. b) Articulation disorders were not found in the cases with mild functional disturbances of the tongue or the soft palate. c) Dysarthria was observed prominently in the right hemiplegic than the left hemiplegic, d) There was no appreciable difference between each sound in the result of the so-called "PA-TA-KA-RA" test. e) The degree of disturbances in the movement of the articulatory organs was not always comparable with the results of "PA-TA-KA-RA" test. The discrepancy would indicate the dyscoordination of central origin. 2) Anditory dysfunctions a) Hearing loss was not remarkable in pure tone audiometry. b) Discrimination scores in speech audiometry were poor, particularly in patients with aphasia. c) Abnormal findings in directional hearing test were obtained in patients with left hemiplegia. d) Abnormal findings in distorted speech test and binaural speech integration test were often obtained particularly in patients with dysarthria, e) In interaural differentiation test, the result of the hemiplegic side was remarkably poorer than that of the non-hemiplegic side. f) Abnormal findings in the special hearing tests were found mostly in those cases with dysarthria with left hemiplegia and aphasia with right hemiplegia. These cases were considered to have severe cerebral disturbances. From these results, it was concluded that speech and auditory function tests including special hearing tests would be significant for investigating the extent and degree of the cerebral lesion in apoplectic patients.
社団法人日本耳鼻咽喉科学会の論文

片麻痺を伴った脳卒中後遺症例に対する聴覚•言語機能検査の診断的意義

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