The Japanese journal of neuropsychology

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ArticleTitle	Palilalia and frontal lobe syndrome associated with a right fronto-temporal infarction
Language	J
AuthorList	Ayumi Tachikawa¹⁾, Toru Imamura¹⁾²⁾, Atsushi Sato³⁾, Toshihide Shu⁴⁾
Affiliation	1)Department of Speech Therapy, School of Health Sciences, Niigata University of Health and Welfare 2)Department of Neurology, Niigata Rehabilitation Hospital 3)Division of Speech Therapy, Department of Rehabilitation, Niigata Rehabilitation Hospital 4)Department of Internal Medicine, Niigata Rehabilitation Hospital
Publication	Japanese Journal of Neuropsychology: 22 (3), 212-218, 2006
Received	Jun 17, 2005
Accepted	Jan 23, 2006
Abstract	We described an 80-years-old right-handed female who exhibited palilalia and right-hemisphere and frontal syndromes after an infarction in the territory of the right middle cerebral artery. Twenty-two months after the onset, a neurological examination showed the left hemiparesis. She was awake but inattentive and easily distractible. She scored 13 on the Mini-mental state examination. Her running speech was fluent with no articulatory disturbances or paraphasia. She could repeat a phrase with 17 syllables. Confrontation naming and pointing of common dally objects were normal. Syntax, comprehension, reading and writing were also normal. There were no ideomotor or ideational apraxia, visual agnosia or visuospatial disturbances. On the other hand, she showed right hemisphere syndromes including motor impersistence, left hemispatial neglect and constructional disturbance. Chronic and intentional perseverations were observed on the sequential tasks and the color-form sorting, respectively. Her word production was poor on the fluency tasks. She showed response disinhibition on the fist-edge-palm task and the red-green task. Utilization behavior was occasionally observed. During the neuropsychological assessments, her verbal response often consisted of palilalia. The palilalia was atonic and homolalic nature, enhanced when her responses were emotional and was often associated with stereotyped tapping with the right hand. Mitigated echolalia was occasionally observed. Palilalia and disinhibited behaviors were apparent in her daily living. Her palilalia was often occurred and enhanced in a situation which stimulates emotional responses. We consider that the neuropsychological bases of her palilalia may include the disturbance of the inhibitory processes of emotional verbal responses.
Keywords	palilalia, echolalia, stereotypia, PES syndrome