A 30-year-old woman hit her head during an automobile accident and was admitted to
the hospital. One week later magnetic resonance imaging (MRI) showed a right frontal/parietal
lesion. Among the behavioral sequelae were mild ataxia with trunkal instability and
dysfluent speech accompanied by prominent shaking of the right leg, face and neck
tension, and facial twitching. The speech-language pathologist thought the patient
was not apha-sic but rather was stuttering and treated her for about a month with
pacing and “easy onset” techniques to which she showed fair response. The diagnostic
question in this case is whether the stuttering was the result of the brain damage
(neurogenic) or of the stressful events she had experienced (psycho-genie). In this
article we review her case and the process we used in arriving at an “expert” opinion.
stuttering - dysfluency - neurogenic stuttering - psychogenic stuttering - closed
head injury
