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Loss of speech after orthotopic liver transplantation

1995; Springer Science+Business Media; Volume: 8; Issue: 3 Linguagem: Inglês

10.1111/j.1432-2277.1995.tb01510.x

1432-2277

David J. Bronster, Patrizia Boccagni, Marian O'Rourke, Sukru Emre, Myron Schwartz, Charles M. Miller,

Organ Transplantation Techniques and Outcomes

Transplant InternationalVolume 8, Issue 3 p. 234-237 Loss of speech after orthotopic liver transplantation David J. Bronster, David J. Bronster 3 East 83rd Street, New York, NY 10028–0450, USASearch for more papers by this authorPatrizia Boccagni, Patrizia Boccagni Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this authorMarian O'Rourke, Marian O'Rourke Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this authorSukru Emre, Sukru Emre Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this authorMyron Schwartz, Corresponding Author Myron SchwartzDivision of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USA Fax: + 1212 996 9688Search for more papers by this authorCharles Miller, Charles Miller Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this author David J. Bronster, David J. Bronster 3 East 83rd Street, New York, NY 10028–0450, USASearch for more papers by this authorPatrizia Boccagni, Patrizia Boccagni Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this authorMarian O'Rourke, Marian O'Rourke Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this authorSukru Emre, Sukru Emre Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this authorMyron Schwartz, Corresponding Author Myron SchwartzDivision of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USA Fax: + 1212 996 9688Search for more papers by this authorCharles Miller, Charles Miller Division of Liver Transplantation, The Mount Sinai Medical Center, Box 1104, One Gustave L. Levy Place, New York, NY 10029–6574, USASearch for more papers by this author First published: May 1995 https://doi.org/10.1111/j.1432-2277.1995.tb01510.xCitations: 23AboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Abstract Abstract Alteration of speech is a rare but distressing complication of orthotopic liver transplantation (OLT). We describe a characteristic speech disorder identified in a large series of consecutive patients undergoing OLT. Between 1988 and 1993, 525 adults underwent OLT. For all recipients with neurologic complications, we reviewed clinical findings, imaging and electrophysiologic test results, and perioperative laboratory data. Five patients (ages 23–52; UNOS status 3–4) exhibited a characteristic pattern of stuttering dysarthria, leading to complete loss of speech production, occasionally with elements of aphasia. In four of the five patients, right-sided focal seizures were subsequently noted. All cases presented within the first 10 postoperative days and improved within 1 month of cessation of cyclosporin (CyA), although halting, monotonous speech was evident to some degree in all five for up to 1 year. There was no correlation between onset of symptoms and CyA levels. None of the patients had clinical or radiologic findings suggestive of central pontine myelinolysis or akinetic mutism. EEGs and Spect scan results were consistent with dysfunction in the left frontotemporoparietal regions of the brain. A characteristic speech disorder, which may be described as cortical dysarthria or speech apraxia, occurs in approximately 1% of adults undergoing OLT. Prompt recognition of this syndrome and temporary cessation of CyA therapy may favorably affect the course. Citing Literature Volume8, Issue3May 1995Pages 234-237 RelatedInformation