Ask the Experts - Any Relationship Between Stuttering and Benign...

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Ask the Experts - Any Relationship Between Stuttering and Benign...
Do you have any information -- anecdotal or otherwise -- regarding a relationship between nocturnal rolandic epilepsy and stuttering?

Balaji Vishwanat, MD

Stuttering appears to be caused by abnormal timing in the neurophysiologic processes involved in producing speech. Stuttering is associated with widespread overactivation of the motor system and reduced activation of auditory regions involved with self-monitoring of speech. Rarely, strokes located in many different brain regions cause stuttering, probably by interfering with these systems.

Several medications, including gabapentin, lamotrigine, clozapine, and theophylline, have been reported to cause stuttering in single case reports. Catania and colleagues reported a patient with benign childhood epilepsy with centrotemporal spikes (BECTS) who developed cognitive impairment and stuttering along with worsened seizures during treatment with valproic acid and lamotrigine. The stuttering and other CNS symptoms resolved after lamotrigine was stopped. This case report seems to illustrate how CNS intoxication (and possibly seizures) can interfere with speech, motor, and feedback systems, and rarely produce stuttering. There are no reports of a direct association between BECTS and stuttering, although perioral seizures may occur with BECTS and in one case produced transient dysarthria. Antiepilepsy drug toxicity and frequent epileptiform activity should be screened for in a patient with nocturnal rolandic seizures and stuttering.

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