Pure Anarthria Without Simultaneous Buccofacial Apraxia in a Luxemburgish Patient

Virtual Reality Augmented Feedback Rehabilitation Associated to Action Observation Therapy in Buccofacial Apraxia: Case Report

Clinical Medicine Insights Case Reports ◽

10.1177/1179547621994579 ◽

2021 ◽

Vol 14 ◽

pp. 117954762199457

Author(s):

Daniele Emedoli ◽

Maddalena Arosio ◽

Andrea Tettamanti ◽

Sandro Iannaccone

Keyword(s):

Virtual Reality ◽

Neural Plasticity ◽

Action Observation ◽

Voluntary Movements ◽

Augmented Feedback ◽

Lower Face ◽

Facial Movements ◽

Upper Face ◽

The Central Nervous System ◽

Buccofacial Apraxia

Background: Buccofacial Apraxia is defined as the inability to perform voluntary movements of the larynx, pharynx, mandible, tongue, lips and cheeks, while automatic or reflexive control of these structures is preserved. Buccofacial Apraxia frequently co-occurs with aphasia and apraxia of speech and it has been reported as almost exclusively resulting from a lesion of the left hemisphere. Recent studies have demonstrated the benefit of treating apraxia using motor training principles such as Augmented Feedback or Action Observation Therapy. In light of this, the study describes the treatment based on immersive Action Observation Therapy and Virtual Reality Augmented Feedback in a case of Buccofacial Apraxia. Participant and Methods: The participant is a right-handed 58-years-old male. He underwent a neurosurgery intervention of craniotomy and exeresis of infra axial expansive lesion in the frontoparietal convexity compatible with an atypical meningioma. Buccofacial Apraxia was diagnosed by a neurologist and evaluated by the Upper and Lower Face Apraxia Test. Buccofacial Apraxia was quantified also by a specific camera, with an appropriately developed software, able to detect the range of motion of automatic face movements and the range of the same movements on voluntary requests. In order to improve voluntary movements, the participant completed fifteen 1-hour rehabilitation sessions, composed of a 20-minutes immersive Action Observation Therapy followed by a 40-minutes Virtual Reality Augmented Feedback sessions, 5 days a week, for 3 consecutive weeks. Results: After treatment, participant achieved great improvements in quality and range of facial movements, performing most of the facial expressions (eg, kiss, smile, lateral angle of mouth displacement) without unsolicited movement. Furthermore, the Upper and Lower Face Apraxia Test showed an improvement of 118% for the Upper Face movements and of 200% for the Lower Face movements. Conclusion: Performing voluntary movement in a Virtual Reality environment with Augmented Feedbacks, in addition to Action Observation Therapy, improved performances of facial gestures and consolidate the activations by the central nervous system based on principles of experience-dependent neural plasticity.

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Buccofacial apraxia and left cerebral haemorrhage

Brain Injury ◽

10.1080/026990597122981 ◽

1997 ◽

Vol 11 (11) ◽

pp. 777-782 ◽

Cited By ~ 5

Author(s):

SHINICHIRO MAESHIMA, GEORGE TRUMAN,

Keyword(s):

Cerebral Haemorrhage ◽

Buccofacial Apraxia

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Mutism associated with buccofacial apraxia and bihemispheric lesions

Brain and Language ◽

10.1016/0093-934x(88)90129-0 ◽

1988 ◽

Vol 34 (1) ◽

pp. 157-168 ◽

Cited By ~ 32

Author(s):

Z. Groswasser ◽

C. Korn ◽

I. Groswasser-Reider ◽

P. Solzi

Keyword(s):

Buccofacial Apraxia

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Lasting mutism associated with buccofacial apraxia

Aphasiology ◽

10.1080/02687039208248598 ◽

1992 ◽

Vol 6 (3) ◽

pp. 285-292 ◽

Cited By ~ 7

Author(s):

David Pineda ◽

Alfredo Ardila

Keyword(s):

Buccofacial Apraxia

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Postcallosotomy language impairments in patients with crossed cerebral dominance

Journal of Neurosurgery ◽

10.3171/jns.1990.72.1.0085 ◽

1990 ◽

Vol 72 (1) ◽

pp. 85-90 ◽

Cited By ~ 43

Author(s):

Kimberlee J. Sass ◽

Robert A. Novelly ◽

Dennis D. Spencer ◽

Susan S. Spencer

Keyword(s):

Left Hemisphere ◽

Verbal Memory ◽

Right Hemisphere ◽

Cerebral Dominance ◽

Language Impairments ◽

Content Type ◽

Left Handed ◽

Buccofacial Apraxia ◽

Clinically Significant ◽

Fine Print

✓ Language impairments were reviewed retrospectively in patients who underwent partial or total corpus callosum section for medically refractory secondary generalized epilepsy. Postoperatively, four of 32 patients had clinically significant language impairments that were not present prior to the operation. All involved primarily verbal output (speech and writing) and spared verbal comprehension. Written language skills (reading and spelling), verbal memory, and verbal reasoning abilities were impaired to varying degrees. These impairments were associated with crossed cerebral dominance. Three patients with severe speech difficulties after surgery were right hemisphere-dominant for speech and were right-handed. One left hemisphere speech-dominant, left-handed patient was agraphic after surgery, but spoke normally. It is concluded from these data and from other reports in the literature that three syndromes of language disturbance may follow callosotomy. The first, involving speech difficulty but sparing writing, is attributable to buccofacial apraxia. The second involves speech and writing difficulties and occurs in right hemisphere-dominant right-handed patients. The third involves dysgraphia with intact speech and occurs in left hemisphere-dominant left-handed patients.

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