Recovery of brain abscess-induced stuttering after neurosurgical intervention

BMJ Case Rep. 2018 May 12:2018:bcr2017223259. doi: 10.1136/bcr-2017-223259.

Abstract

Stuttering occurs in approximately 5% of all children and 1% of adults. One type, neurogenic stuttering, is usually attributable to strokes or other structural damages to the brain areas that are responsible for language fluency. Here, we present the first case of neurogenic stuttering caused by a brain abscess. The patient was a 60-year-old man admitted for a seizure and administered an anticonvulsant, after which he began stuttering. MRI revealed a brain abscess in the left frontal lobe that extended to the dorsolateral prefrontal cortex (BA (Brodmann's area) 9 and 46), frontal eye field (BA 8) and premotor cortex and supplementary motor area (BA 6). After neurosurgical drainage and antibiotic treatment, the symptoms had resolved. This case is unique in that the therapeutic effects and localisation of the cause of stuttering were rapidly identified, allowing for a more accurate description of the neural circuitry related to stuttering.

Keywords: infection (neurology); neuroimaging; neurosurgery.

Publication types

  • Case Reports

MeSH terms

  • Anti-Bacterial Agents / therapeutic use*
  • Anticonvulsants / therapeutic use
  • Brain Abscess / complications
  • Brain Abscess / diagnostic imaging*
  • Brain Abscess / therapy
  • Drainage*
  • Humans
  • Magnetic Resonance Imaging*
  • Male
  • Middle Aged
  • Neurosurgical Procedures
  • Prefrontal Cortex / pathology*
  • Seizures / drug therapy*
  • Seizures / etiology
  • Stuttering / diagnostic imaging*
  • Stuttering / etiology
  • Stuttering / therapy
  • Treatment Outcome

Substances

  • Anti-Bacterial Agents
  • Anticonvulsants