兒童後天神經性語言障礙：神經性緘默症的個案研究

Childhood Acquired Neurologicl Language Disorders : A Case Report of Acquired Neurological Mutism

陳信華(Hsin Hua Chen) ； 周琪(Julie Chi Chow) ； 傅嘉麟(Chia-Lin Fu) ； 林殿富(Dian-Fu Lin) ； 林孟輝(Meng-Huei Lin)

《中華民國聽力語言學會雜誌》 17期 (2002/11) Pp. 1-14

https://doi.org/10.6143/JSLHAT.2002.11.01

摘要

本文探討兒童時期因腦傷所致神經性緘默症（neurologic mutism ）的成因以及臨床表現。臨床上，兒童神經性緘默症可能出現於各種腦部損傷的案例，最常見的研究有後腦窩（posterior fossa）腫瘤手術後緘默症。緘默期可能立即於腦損傷後發生，也可能延至數天後，期間通常由幾天至數個月不等。本文呈現一位兒童個案因溺水意外事件導致腦部損傷，其語言溝通功能出現短暫性的神經性緘默症，伴隨有吶吃症狀的言語障礙。個案的神經檢查反映雙側腦的前額下回區的局部腦血流量降低。個案目前沒有明顯的聽覺理解困難，但有嚴重口語表達困難。

關鍵字

緘默症 ； 吶吃症

並列摘要

Acquired neurological mutism in childhood arising after brain lesions and surgical operations is a period of transient loss of speech. Transient mutism usually occurs in pediatric patients after posterior fossa surgery. The case of a 6-year-old boy is presented, who developed transient mutism after an accident event of drowing. The transient mutism persisted for 1-2 months and was followed by cerebellar dysarthria. The case is discussed with regard to its etiology, assessments, and language performances.

參考文獻

Dietze, D. D.,Mickle, J. P.(1990).Cerebellar Mutism after Posterior Fossa Surgery.Pediatr Neurosurg.16,25-31.

Aguiar, P. H.,Plese, J. P. P.,Ciquini, O.,Marino, R.(1995).Transient Mutism following a Posterior Fossa Approach to Cerebellar Tumors in Children: A Critical Review of the Literature.Childs Nerv System.11,306-310.

Dailey, A. T.,McKhann, G. M.,Berger, M. S.(1995).The Pathophysiology of Oral Pharyngeal Apraxia and Mutism following Posterior Fossa Tumor Resection in Children.Journal of Neurosurgery.83,467-475.

Doxey, D.,Bruce D.,Sklar F.,Swift, Dale,Shapiro, K.(1999).Posterior Fossa Syndrome: Identifiable Risk Factors and Irreversible Complications.Pediatr Neurosurg.31,131-136.

Pollack, I. F.,Polinko, P.,Aibright, A. L.,Towbin, R.,Fitz, C.(1995).Mutism and Pseudobullbar Symptoms after Resection of Posterior Fossa Tumors in Children: Incidence and Patyophysiology.Neurosurgery.37(5),885-893.