Palilalia after traumatic intracerebral hemorrhage (a case report)

Abstract

This report refers to the 4-year long diachronic observation of a case of acquired palilalia caused by intracerebral hemorrhage due to head trauma. It was approximately 7 months after his trauma that the patient began exhibiting striking palilalia behavior along with echolalia and a global deterioration of mental activities. Palilalia was still present 2 years later in spite of some degree of general improvement. A peculiarity of this patient was that palilalia occurred in response to relatively complex questions whereas it was hardly present in response to simpler ones. Contrary to observations made in other cases of palilalia, instrumental sound analyses revealed that articulation speed, although somewhat fast, did not keep increasing as palilalic utterances went on, and that vocal intensity remained within normal ranges, i.e. did not decrease from the onset of a given palilalic utterance to its end. CT-scan and MRI imaging showed the brain lesion to be almost restricted to the cortex of the right frontal convexity and its underlying white matter. It is suggested that palilalia is, in certain cases caused by a disturbance of higher motor speech control mechanisms.