the rostral cerebellum C7, 9, 111. In most patients, however, dysarthria was described as "mild" or as "slurred speech" and was associated with other symptoms, mainly ipsilateral dysmetria of the limbs and axial lateropulsion. The area involved was the anterior part of the rostral cerebellum C7, 11, 121, that is, the territory of the lateral branch of the superior cerebellar artery, and not the paravermal zone. The present patient with severe isolated cerebellar dysarthria indicates that, as suggested by Lechtenberg and Gilman 111, the posteromedial (paravermal) part of the rostral cerebellum supplied by the mSCA plays a major role in the control of vocalization and speech.
The higher incidence of dysarthria in left cerebellar lesions raises an interesting point. Ropper C63 reported 10 patients with severe dysarthria and right-hemisphere stroke. The smallest infarct involved the right frontal operculum. According to Lechtenberg and Gilman 111, there are connections between the left cerebellum and right cerebral hemisphere. Ropper [GI suggested that some aspect of severe dysarthria from the right hemisphere, such as modulation of speech, results from involvement of these connections, which are also illustrated by positron emission tomographic scanning observations of cross cerebellar diaschisis in frontoparietal infarcts {151.
We thank Dr Bryan You1 for his help with the English text.
'Intrasubjecr correlation coefficient. bLiiits of 95% confidence interval (CI) of r.