Prosody Disorder and Sing-Song Speech in a Patient With Recurrent Glioblastoma: A Case Report

Dysprosody affects rhythm and intonation in speech, resulting in the impairment of emotional or attitude expression, and usually presents as a negative symptom resulting in a monotonous tone. We herein report a rare case of recurrent glioblastoma (GBM) with dysprosody featuring sing-song speech. A 68-year-old man, formerly left-handed, with right temporal GBM underwent gross total resection. After chemoradiation therapy, he was discharged without any deficits. Nineteen months later, the patient exhibited recurrence and presented a peculiar way of speaking with excessive melodic intonation. A head magnetic resonance imaging revealed new enhanced lesions in the residual right temporal lobe and the splenium of the corpus callosum with a massive surrounding T2-high area. The case highlights the bilateral hemispheric network underlying prosody and the compensatory failure caused by tumor progression and connectivity disruption. This first account of sing-song dysprosody in a GBM patient underscores the complexity of the language network and the need for further case accumulation to elucidate the pathophysiology of such rare presentations.