A case of persistent neurogenic stuttering following a missile wound

Observational criteria that have been proposed to distinguish developmental from neurogenic stuttering are critically reviewed. It is concluded that both conditions may closely resemble each other. As an example, a case of neurogenic stuttering following a missile would is reported.     

Cluttering after brain damage

On the basis of published cases and of observations made in two patients, a syndrome of acquired cluttering after brain damage in adults is delineated, and a hypothesis is presented regarding the patho-physiology of the disorder.     

Acquired stuttering as a forerunner of motor-neuron disease

A case of acquired stuttering that included repetitions, blocks, prolongations, fillers, and, later on, also synkinesias is reported. This stutter turned out to be the forerunner of a motor-neuron disease.     

Macropremies: underprivileged newborns

The focus of neonatal intensive care has been on very low birthweight infants, who comprise only 1.4% of neonates. Too little attention is paid to moderately preterm infants that we call macropremies or moderately low birthweight infants (MLBW, with birthweights 1500-2500 grams). Admitting over half MLBW infants to normal nurseries presumes that they have few needs and an excellent prognosis similar to fullterm newborns. It does not take into account the macropremie's vulnerability to complications of prematurity due to immature organ systems. Obstetricians are increasingly willing to deliver these infants prematurely for signs of fetal distress. As many as 25% of children with cerebral palsy referred to a disability clinic in Paris were MLBW, with hypoxic-ischemic-inflammatory associated disorders in one-third. The majority of MLBW infants who required neonatal intensive care at a tertiary care center in Baltimore had complications of prematurity: 47% had respiratory problems, 20% had feeding intolerance and 9% had hypoglycemia. MLBW infants comprise 5-7% of the neonatal population but account for 14% of neonatal deaths, 18-37% of children with cerebral palsy and 7-12% of children with mental retardation. Increasing the level of neonatal care for the macropremie's transition to extrauterine life would be economically feasible if it prevented as few as 30% of cases of major disability. A change in attitude towards this low risk (but not risk free) group of MLBW infants will both reduce morbidity and improve their health and neurodevelopmental outcome. It includes: 1) Providing an intermediate level of neonatal care for a short duration, with close monitoring and prompt intervention as needed, and 2) Neonatal neurodevelopmental screening to allow focused neurodevelopmental followup of MLBW infants with abnormalities.     

Hypertonic saline mimics the effects of vasopressin on inhibitory avoidance in the rat

Rats tested in a step-through inhibitory avoidance task were administered hypertonic saline (2 ml of 0.25. 0.5, and 1.0 M intraperitoneally) or arginine vasopressin (1.0, 2.0, and 4.0 micrograms) injected subcutaneously (sc) after the training trial where the rats received a mild footshock (0.2 mA, 3 s). Both hypertonic saline and vasopressin produced significant increases in latency to reenter 24 h later. These treatments failed to increase reentry latencies in animals that received the same procedure but no shock. The facilitation of inhibitory avoidance produced by hypertonic saline was reversed by sc administration of 25 micrograms of the vasopressor (V-1) vasopressin antagonist, dPtyr(Me)AVP. The results suggest that the endogenous release of vasopressin can be behaviorally significant in situations of acute homeostatic challenge.     

Acquired stuttering

Working from a case of degeneration of the nervous system accompanied by stutterlike repetitions, this article raises the question whether patients should be said to have acquired stuttering when they evidence only one of the typical symptoms of the syndrome. On the other hand, it is shown that when acquired stuttering is polysymptomatic, it can hardly be distinguished from developmental stuttering on the basis of the patient's verbal behavior. This may have important medicolegal implications. When acquired stuttering occurs in the context of aphasia, both affections appear to be relatively independent of each other. Specifically, there seems to be no causal relationship between them.