Post-stroke parkinsonism ; Hypophonic dysarthria ; Lee Silverman Voice Treatment
Abstract
Post-stroke parkinsonism usually presents with bradykinesia, resting tremor, and movement
disabilities and reportedly responds poorly to rehabilitative and pharmacological treatment
in contrast to Parkinson’s disease. However, we encountered a patient with subarachnoid
hemorrhage caused by a ruptured anterior communicating artery aneurysm who developed
parkinsonism, which manifested with hypokinetic hypophonic dysarthria and masked facies.
Brain 18F-fluorodeoxyglucose positron emission tomography/computed tomography revealed
decreased glucose metabolism in the bilateral basal ganglia. He underwent 18 sessions of
Lee Silverman Voice Treatment (LSVT) for 60 min, once daily, and he gradually increased the
previously prescribed doses of levodopa and benserazide to 200 mg and 50 mg, respectively,
three times a day. The patient’s dysarthria improved from moderate to mild dysarthria. His
masked facies also improved remarkably 6 weeks after admission. Along with levodopa
administration, LSVT could be suggested as an effective treatment tool for hypophonic
dysarthria due to post-stroke parkinsonism.