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   Table of Contents      
CASE REPORT
Year : 2017  |  Volume : 3  |  Issue : 3  |  Page : 159-161

Late-onset Development of Tachylalia Following a Closed Traumatic Craniocerebral Injury Associated with Bitemporal Gliosis


1 RED LATINO, Latin American Trauma & Intensive Neuro-Care Organization, Bogota, Colombia
2 All India Institute of Medical Sciences, New Delhi, India
3 Hospital General Dr. Manuel Gea González, Universidad Nacional Autonoma de Mexico, Ciudad de Mexico, Mexico
4 Department of Neurosurgery, Narayana Medical College & Hospital, Chinthareddypalem, Nellore, Andhra Pradesh, India

Date of Web Publication24-Oct-2017

Correspondence Address:
Luis R Moscote-Salazar
RED LATINO, Latin American Trauma & Intensive Neuro-Care Organization, Bogota
Colombia
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/mamcjms.mamcjms_35_17

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  Abstract 

Tachylalia is defined as extremely rapid output of speech. A case of delayed development of tachylalia 4 years following sustaining a closed craniocerebral injury is reported. We suggest that the management of communication disorders should always be considered as a part of treatment and rehabilitation of traumatic head injury. In a detailed PubMed and Medline search for late-onset tachylalia, development following traumatic craniocerebral injury did not yield even a single report in the literature. The multidisciplinary approach in management of such rare event is highly crucial.

Keywords: Brain trauma injury, communication disorders, tachylalia


How to cite this article:
Moscote-Salazar LR, Satyarthee GD, Matus JA, Calderon-Miranda WG, Hernandez NE, Reddy BU, Agrawal A. Late-onset Development of Tachylalia Following a Closed Traumatic Craniocerebral Injury Associated with Bitemporal Gliosis. MAMC J Med Sci 2017;3:159-61

How to cite this URL:
Moscote-Salazar LR, Satyarthee GD, Matus JA, Calderon-Miranda WG, Hernandez NE, Reddy BU, Agrawal A. Late-onset Development of Tachylalia Following a Closed Traumatic Craniocerebral Injury Associated with Bitemporal Gliosis. MAMC J Med Sci [serial online] 2017 [cited 2019 Aug 18];3:159-61. Available from: http://www.mamcjms.in/text.asp?2017/3/3/159/217120


  Introduction Top


Traumatic brain injury is a global public health problem. Traumatic brain injury may cause alterations of various anatomic structure of cerebral parenchyma, including communication by shearing force, intracerebral hematoma, contusion, or infarct. Fresh onset language disorder development in patients with traumatic brain injury is reported as the Edwin Smith papyrus observation. Tachylalia is defined as extremely rapid output of speech.[1],[2],[3] It occurs in many clutterers and many people also suffer with associated speech disorders. Recently, several studies demonstrated participation of two interconnections in dynamic language formation: a frontoparietal system and other temporoparietal. Today, the classic classifications that have been used in disorders of vascular origin shall comply with the alterations in patients with cerebral traumatic injury. We report the case of a managed service in our neurosurgery patient.


  Case Report Top


A 40-year-old male reported to neurosurgery consultation with a complaint of “fast talking” for 6 months. On physical examination, vital parameters were normal. In the neurological examination, the patient was alert, with tachylalia without sensory, motor disturbances. The brain computed tomography scan [Figure 1] showed large areas of posttraumatic encephalomalacia on both temporal lobes. The patient was sent for speech therapy rehabilitation with regular follow-up in outpatient with neurologist speech therapist. In patients with tachylalia, the fast speech rate, the fluency of speech, and word structure remains intact. In patients with cluttering, a fast speech rate is often associated with shorter pauses in linguistically wrong place, but pausing in tachylalia is shorter and occurs at appropriate places.
Figure 1: (A and B) Noncontrast computed tomography scan of brain showing presence of large areas of encephalomalacia on both the temporal lobes.

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  Discussion Top


Tachylalia means excessively rapid speech. The literal meaning of tachylalia in Greek is tachys means swift + lalia meaning speech. Tachylalia is defined as extremely rapid output of speech without a neurological or psychological etiology. However, tachylalia needs to be differentiated from cluttering.[1],[2] cluttering is defined as speech frequency problem in linguistic syntactic with phonetic demands of the moment. However, person with tachylalia doesn’t exhibit poor intelligence, normal disfluence, or error in pause. It occurs in many clutterers and many people also suffer with associated speech disorders. The Dales signs of clutters are poor awareness and self-monitoring skills; rapid speech rate with poor intelligibility, lack of pauses between words; run-on sentences, telescopes, or condenses words; disorganized language with trouble in sequencing, imprecise articulation with distortion, and omission of sounds irregular speech rate; speaking in spurts, compulsive talker, different circumlocutions, repetitions of multi-syllabic phrases and words, absence of excessive effort during disfluencies, and betterment of speech under pressure with revisions of interjections.[4]

However, tachylalia is a generic term for speaking fast and can always be associated with other speech problems. Isolated manifestation of tachylalia is not considered a speech disorder.[3]

Tachylalia may be exhibited as a single stream of rapid speech without prosody and can be delivered quietly or mumbled. Tachylalia can be simulated by stimulating the brain electronically.[3] Tachylalia can occur as a part of cluttering, Parkinson’s disease, cluttered speech, and even in normal speech.[1],[2],[3]

The process of language production is done through various neural mechanisms. Multiple components of the cerebral cortex are required for the production of muscle patterns required for the issuance of words (auditory information-temporal lobe, somatosensory information-parietal lobe, motor information-frontal lobe). Connections are also involved in the cerebellum, basal ganglia, and brain stem.

After traumatic brain injury, various alterations of communications can occur. Aphasia, dysarthria, and apraxia are among the most diagnosed disorders, also described neurolinguistic deficit. The multidisciplinary management for victims of traumatic brain injury is essential. The quality-of-life evaluation is also very important as well as all strategies to preservation of life. The realization of rehabilitation to improve language and communication skills should be part of the monitoring required by our patients. Improving patient communication should be the main objective.

Dordain et al. analyzed speech subjectively with listening to recordings and measurement of durations in 67 Parkinsonians patients, and additional 10 cases suffering from neurological disorders and another 72 cases suffering with psychiatric illness. Acceleration of speech was greatest in the Parkinsonians. The duration of a sentence read by several of tachylalia Parkinsonians was the same as for normal control patients reading as fast as they could. Almost half of the tachylalic Parkinsonians (44%) had a speaking time shorter than the shortest duration recorded among same-age normal controls.[3]


  Conclusion Top


Patients developing tachylalia should be thoroughly investigated with appropriate neuroimaging and detailed neurological evaluation with neuropsychological assessment that needs to be carried out. Patients should be properly rehabilitated. However, treating neurosurgeons and health-care team should be aware of development of tachylalia as a sequlae of posttraumatic craniocerebral injury.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.

 
  References Top

1.
Van Riper C. Stuttering and cluttering. Folia Phoniatr (Basel) 1970;22:347-53.  Back to cited text no. 1
[PUBMED]    
2.
Freund H. Observations on tachylalia. Folia Phoniatr (Basel) 1970;22:280-8.  Back to cited text no. 2
    
3.
Dordain M, Chevrie Muller C, Guidet C. Tachylalia: Clinical and acoustic study of 149 subjects (author’s transl). Acta Neurol Belg 1978;78:354-72.  Back to cited text no. 3
    
4.
Daly DA, Burnett ML, (1999), Cluttering: Traditional views and new perspectives. In: Curlee RF, editor. Stuttering and Related Disorders of Fluency. New York: Thieme Medical Publishers, Inc.; 1999.  Back to cited text no. 4
    


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