Dysarthria at a Glance

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Dysarthria at a Glance
Patrick McCaffrey, Ph.D ([email protected]), Professor/Coordinator, Speech Pathology Graduate Program, California State University, Chico Copyright 2000. Patrick McCaffrey, Ph.D. This page is freely distributable. This chart was designed by Kaelin Lundgren, Fall 1999.

Upper Motor Neuron Dysarthria Ataxic Site of Lesion Cerebellar Hyperkinetic Hypokinetic Spastic Only bilateral lesions of the pyramidal tract cause severe cases (pseudobulbar palsy) Slow, labored, imprecise, often unintelligible; may be compounded with respiration, resonation and phonation disturbances Reduced facial expression AKA masked facies Generalized hypotonicity, weakness, sometimes immobility, abnormal force physiology and exaggerated reflexes Pseudobulbar palsy Weak voice, harsh, pitch is low, may have pitch breaks All prognoses are dependent upon neurological status and history, as well as age, treatment effects, personality, intelligence and support systems. Possible bursts of loudness

Low er Motor Neuron Dysarthria Flaccid LMN neurons involved in speech (CN V, VII, IX, X, XI, XII) Inaccuracy, imprecise consonants, irregular articulatory breakdowns, vowel distortion, prolonged phonemes Atrophy over time, fasciculations especially of the tongue, jaw deviates to weakened side while tongue veers to stronger side.

Extrapyramidal tract, specifically the basal Substantia nigra in Parkinson's, but may ganglia; may be unilateral or bilateral be effect of drugs, blows to the head May not be impaired in some syndromes; Chorea-imprecise, Dystonia-irregular Very slow or festinating

Articulation

Slurred, severely impaired

Associated Characteristics

Reduced facial expression AKA masked facies Prosody and gait affected

Reduced facial expression AKA masked facies Varies with Chorea (quick involuntary) and Dystonia (slow, writhing) but all are superimposition of automatic movements upon volitional movements Chorea and Dystonias Abnormal in essential tremor syndrome All prognoses are dependent upon neurological status and history, as well as age, treatment effects, personality, intelligence and support systems. Dystonia may have voice stoppages

Reduced facial expression AKA masked facies Tremors; festinating movements, weak voice, respiration may be affected

Neurological Disorders Phonation Prognosis

Cerebellar ataxia Harsh, loudness may vary excessively All prognoses are dependent upon neurological status and history, as well as age, treatment effects, personality, intelligence and support systems. Pronounced problems, tendency to place equal stress on all syllables. Hypernasality not common, but may occur Slurred, sometimes described as explosive speech

Parkinson's disease Hoarse, low volume All prognoses are dependent upon neurological status and history, as well as age, treatment effects, personality, intelligence and support systems. Monopitch, monoloudness, pallilalia, articulatory undershoot Hypernasality Bradykinesia causes very slow speech, or festinating speech.

Bulbar palsy

All prognoses are dependent upon neurological status and history, as well as age, treatment effects, personality, intelligence and support systems. Slow rate and prolonged intervals, monopitch and monoloudness with vocal fold paralysis Hypernasality if velar elevation effected, may have nasal emission Slow rate, prolongation of sounds and intervals.

Prosody

R eso n an ce S p eech

Hypernasality is common Varied across syndromes and ranging from total unintelligible to mild problems. See note below.

Hypernasality typical without nasal emission Reduced range of movement, tongue strength, VOT for stops May be moderately affected

Sw allow ing Notes Dworkin generally recommends therapy of force physiology training and phonetic stimulation across contexts Muscle movement facilitated by dopaminergic and cholinergic pathway balance (Ferrand and Bloom, 1997)

Emotional lability may be noted

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