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tional and emotional speech (see above) The patient recognizes his ineptitude and mistakes Repeated failures in speech cause exasperation or despair As a result of damage to the adjacent prerolandic motor area, the arm and lower part of the face are usually weak on the right side, and occasionally the leg as well The tongue may deviate away from the lesion, ie, to the right, and be slow and awkward in rapid movements For a time, despite the relative preservation of auditory comprehension and the ability to read, commands to purse, smack, or lick the lips or to blow and whistle and make other purposeful movements are poorly executed, which signi es that an apraxia has extended to certain other learned acts involving the lips, tongue, and pharynx In these circumstances, imitation of the examiner s actions with orofacial muscles is performed better than execution of acts on command Self-initiated actions, by contrast, may be normal By implication from imaging ndings in patients with apractic speech, the co-ordination of orobuccolingual movements, which are responsible for articulation, takes place in the left insular cortex (see Dronkers) rather than primarily in the Broca s area Scanning by positron emission tomography (PET) shows activation of the insular region as well as of the lateral premotor cortex and the anterior pallidum during repetition of single words (Wise et al) It would be incorrect, however, to conclude from these studies that Broca s area itself does not participate in the composition of articulatory movements during natural speech code 39 word download Free Medium-Size Code 39 Font Discontinued - IDAutomation
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