Article Text

Download PDFPDF
Isolated dysarthria due to extracerebellar lacunar stroke: a central monoparesis of the tongue
  1. Peter P Urbana,
  2. Susanne Wichta,
  3. Hanns Ch Hopfa,
  4. Susanne Fleischerb,
  5. Otmar Nickelc
  1. aDepartment of Neurology, bDepartment of Communication Disorders, cDepartment of Nuclear Medicine, University of Mainz, Germany
  1. Dr Peter P Urban, Department of Neurology, University of Mainz, Langenbeckstrasse 1, D 55101 Mainz, Germany. Telephone 0049 6131 175162; fax 0049 6131 173271.


OBJECTIVES The pathophysiology of dysarthria can preferentially be studied in patients with the rare lacunar stroke syndrome of “isolated dysarthria”.

METHODS A single study was carried out on seven consecutive patients with sudden onset of isolated dysarthria due to single ischaemic lesion. The localisation of the lesion was identified using MRI. The corticolingual, cortico-orofacial, and corticospinal tract functions were investigated using transcranial magnetic stimulation. Corticopontocerebellar tract function was assessed using 99mTc hexamethylpropylene amine oxime-single photon emission computerised tomography (HMPAO-SPECT) in six patients. Sensory functions were evaluated clinically and by somatosensory evoked potentials.

RESULTS Brain MRI showed the lesions to be located in the corona radiata (n=4) and the internal capsule (n=2). No morphological lesion was identified in one patient. Corticolingual tract function was impaired in all patients. In four patients with additional cortico-orofacial tract dysfunction, dysarthria did not differ from that in patients with isolated corticolingual tract dysfunction. Corticospinal tract functions were normal in all patients. HMPAO-SPECT showed no cerebellar diaschisis, suggesting unimpaired corticopontocerebellar tract function. Sensory functions were not affected.

CONCLUSION Interruption of the corticolingual pathways to the tongue is crucial in the pathogenesis of isolated dysarthria after extracerebellar lacunar stroke.

  • dysarthria
  • lacunar stroke
  • corticobulbar tract
  • magnetic evoked potentials

Statistics from

Request Permissions

If you wish to reuse any or all of this article please use the link below which will take you to the Copyright Clearance Center’s RightsLink service. You will be able to get a quick price and instant permission to reuse the content in many different ways.