Effect of the Lee Silverman Voice Treatment on Hypophonic Dysarthria from Post-stroke Parkinsonism: A Case Report

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.