Palilalia is a speech disorder where one or more syllables, words or short sentences are repeated involuntarily. The palilalia can be spasmodic – compulsive repetition of utterances without maintaining the speed of speech and amplitude of the voice – or atonic – repetition of utterances constantly, alternating with phases of silence. This disorder affects both women and men, with a higher prevalence in people with brain damage.

Definition of palilalia

Palilalia is a speech disorder where one or more syllables, words or short sentences are repeated involuntarily. The term palilalia paraphasia is preferred when it comes to groups of words or sentences.

Palilalia should not be confused with stuttering. The latter is an anomaly of verbal fluency when the palilalia is a production of excess words.

Concretely, the palilalia resides in a problem of correspondence between the auditory perception of a word and its motor representation. Palilalia often appears during spontaneous speeches, formulating sentences from everyday life, describing pictures or answering questions.

Palilalia is frequently observed in patients with lesions of central motor neurons – neurons directly linked to muscles – such as victims of cerebrovascular accident (stroke) or people with Alzheimer’s disease. Palilalia is also manifested in patients suffering from so-called post-encephalitic Parkinson’s disease, ie triggered following inflammation of the brain.

Types of palilalies

Two types of palilalies exist:

• Spasmodic or heterolalic palilalia is characterized by compulsive repetition of utterances without maintaining the speed of speech – the patient can speak more and more quickly – and the amplitude of the voice – the patient speaks more or less loudly from beginning to end. end ;
• The atonic or homolalic palilalia is concretized by a repetition of the utterances in a constant manner, alternating with phases of silence.

Causes of palilalia

Several causes can be at the origin of palilalia:

• In the majority of cases, the palilalia results from a dysfunction of the articulator. The articulator brings together the organs involved in the production of speech and includes the lips, tongue, larynx and pharynx. It represents the motor part of speech. That is to say that the information necessary to form a word or a sentence is correctly produced by the brain, but their motor translation is faulty;
• Brain damage. Palilalia can occur as a result of brain damage. It is noted in this case that an alteration of the word search process is at the origin of the generation of iterations, in particular monosyllabic. When the person does not find the desired word, the palilalia plays the role of “filling” to fill the void;
• Side effects related to drug treatments. This is, for example, one of the very rare side effects of clozapine, prescribed for the treatment of schizophrenia, or of levodopa, for the treatment of Parkinson’s disease;
• Anxiety remains a cause to be explored, but a 2015 study suggests that environmental-generated anxiety could induce palilalia.

Diagnosis of palilalia

In order to diagnose a palilalia, two conditions must be met:

• The patient repeats a word or several words for no apparent reason and involuntarily;
• The patient knows the words, he has not lost track of each of them. He knows how to count, to name the letters of the alphabet.

People affected by palilalia

Palilalia affects both women and men, with a higher prevalence in people with brain damage – linked to stroke, autism disorder or diseases such as Parkinson’s disease.

Factors favoring palilalia

Different diseases, particularly related to lesions or brain disorders, can promote the occurrence of palilalia:

• Parkinson disease ;
• Alzheimer’s disease ;
• Gilles de la Tourette syndrome;
• Epilepsy;
• Autism spectrum disorder;
• Intellectual disability ;
• And many more

Verbal repetitions

Palilalia, whatever its type, causes the involuntary repetition of one or more syllables, words or short sentences.

Changing the Rhythm of Speech

The repetitions will see their rhythm modified in the same sentence during a spasmodic palilalia.

Changing the amplitude of the voice

The repetitions will have their amplitude modified in the same sentence during a spasmodic palilalia.

Treatment for palilalia depends on its cause.

If palilalia is a side effect of drug treatment, reducing the dose of the molecule –as prescribed by a healthcare professional– is one possible way of reducing the language disorder.

If the palilalia is linked to a disorder of the articulator, work on psychomotricity is necessary with the help of speech therapy sessions.

There is no drug treatment for palilalia.

Preventing palilalia remains complex, but better management is possible by:

• Making short sentences and daring to take breaks;
• Using non-verbal language: gestures facilitate understanding and attention;
• Helping others. Palilalia may subside when a loved one repeats – or sings – the syllables or words on which the person with palilalia blocks;
• Relaxing – meditation, yoga – and avoiding the consumption of stimulants.