PATHOPHYSIOLOGY AND TREATMENT OF SPEECH DISORDERS

颌骨过大的口腔下颌骨张力障碍患者 咬合或张开在颌肌水平上与对照组进行比较 在3个平面上进行简单下颌运动时的活动度。那些有下巴的人 咬合力增加了咬肌活动的水平。然而，那些拥有 张开的颌骨在两个前腹都没有增加水平 二腹肌或翼骨外侧。相反，肌肉的水平 开口器的活动不会随着下巴运动的改变而改变 方向。这种肌肉活动正常模式的缺失可能 解释为什么过度张开颌骨的患者不能从 用肉毒杆菌毒素治疗。 氯丙咪嗪与地塞帕明的双盲交叉对照试验 口吃的成年人完成了口吃。提高了语音流畅性 对服用氯丙咪嗪而不是 地塞帕明。然而，有一些个体差异 对氯丙咪嗪没有改善的个体。一年来的长期影响 现在正在对这些人进行安慰剂间隔一年的研究 他选择了这两种药物中的任何一种进行一年的试验。结果是 令人鼓舞的是，建议修改5-羟色胺可能会改善语言能力 流畅性。 口吃患者对甲状腺素注射治疗的反应 肉毒杆菌毒素与内收肌痉挛患者的比较 发音困难和声带震颤。口吃的受试者较短 优惠期，并且不太可能回来重新注射 另外两组。此外，口吃的受试者 受到副作用的困扰，尽管这些持续的时间不比 其他患者组。因此，尽管言语不流利可能会 病情好转后，患者的治疗效果并不明显。 透视。

Patients with oromandibular dystonia who had either excessive jaw clenching or opening were compared with controls on levels of jaw muscle activity during simple mandibular movement on 3 planes. Those with jaw clenching had increased levels of masseter activity. However, those with jaw opening did not have increased levels in either the anterior belly of the digastric or the lateral pterygoid. Rather, the levels of muscle activity in the jaw openers did not change with changes in jaw movement direction. This absence of the normal pattern of muscle activity may explain why patients with excessive jaw opening do not benefit from treatment with botulinum toxin. The double blind crossover trial comparing clomipramine and desipramine in stuttering was completed in stuttering adults. Speech fluency improved significantly for the group as a whole on clomipramine and not on desipramine. However, there were individual differences with some individuals not improving on clomipramine. The long term effects over a year with a placebo interval are now being studied on those individuals who selected either medication for a one year trial. The results are encouraging and suggest that modifying serotonin may improve speech fluency. Stuttering subjects responses to treatment with thyroarytenoid injection of botulinum toxin were compared with patients with adductor spasmodic dysphonia and vocal fold tremor. The stuttering subjects had shorter periods of benefit and were less likely to return for re-injection than the other two groups. In addition, the stuttering subjects were more disturbed by the side effects, although these did not last longer than in the other patient groups. Thus although speech dysfluency may have improved, the treatment was not beneficial from the patients' perspectives.