Selective impairment of phonation: A case study

Robert C. Marshall, Jack Gandour, Jennifer Windsor

Research output: Contribution to journalArticlepeer-review

21 Scopus citations


A 47-year-old right-handed man underwent craniotomy for clipping of an aneurism at the trifurcation of the left middle cerebral artery. Subsequently, he suffered a left hemisphere CVA after which his speech and language resembled that of Broca's aphasia with accompanying apraxia of speech. Medical, behavioral, and acoustical data amassed over a period of several months indicated numerous contraindications to traditional diagnoses of Broca's aphasia, apraxia of speech, and dysarthria. Ultimately, it was determined that the patient had a selective impairement of phonation or laryngeal apraxia. This was illustrated dramatically when he was taught to use an electrolarynx which allowed him to bypass his disrupted phonatory system. Speaking with the electrolarynx, the patient communicated normally. Any semblance of Broca's aphasia disappeared. Supralaryngeal articulation was normal; apraxia of speech behaviors were absent. This case report indicates that dissociation of oral and laryngeal gestures due to brain injury is possible. Mechanisms underlying such a dissociation for this case are reviewed. The possibility of discrete center lesions in the frontal motor association area causing different types of apraxia of speech is discussed.

Original languageEnglish
Pages (from-to)313-339
Number of pages27
JournalBrain and Language
Issue number2
StatePublished - Nov 1988

Bibliographical note

Funding Information:
This research was supported in part by the Veterans Administration Merit Review Program (first author) and by NIH Grant NS24539 (second author). Reprint requests should be sent to Robert C. Marshall, Ph.D., Audiology and Speech Pathology Service, Veterans Administration Medical Center, Portland, OR 97207.

ASJC Scopus subject areas

  • Experimental and Cognitive Psychology
  • Speech and Hearing
  • Cognitive Neuroscience
  • Language and Linguistics
  • Linguistics and Language


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