Dysarthria definition:
 
 
 

Neuromuscular control of speech

3 motor systems:

1. pyramidal

function:

UMN -

LMN -

2. extrapyramidal

function:

3. cerebellar

function:

Major responsibility of the motor systems is to:
 
 

Lesions and Motor Symptoms

UMN

spastic paralysis:

hypertonia:

hyperactive stretch reflex:

pathologic reflexes:

flaccid paralysis:

hypotonia:

atrophy:

absent reflexes:

hypertonia:

abnormal posture:

paucity of movement:

dyskenesia:

• athetosis

• chorea

• tremors

poor equilibrium and balance

discoordination:

• dysmetria

• ataxia

extra movements:

• intention tremor

Varieties of Dysarthria

We'll describe the different types of dysarthria in terms by looking at the perceptual characteristics (how it sounds) relating to speech production:

• pitch
• loudness
• voice quality
• respiration
• prosody
• articulation
• overall intelligibility and bizarreness

Flaccid Dysarthria

Lesion:

Causes: viral infection, tumor, CVA, trauma;

myasthenia gravis
 
 

typical neuromuscular symptoms:

paralysis -

• weakness
• hypotonia
• muscle atrophy
• fasciculations -

perceptual characteristics

• breathy voice quality

• hypernasality

• consonant imprecision

• audible inspiration

Spastic Dysarthria

Lesion:

Causes: viral infection, tumor, CVA, trauma, CP;

Hallmark:

typical neuromuscular symptoms:

paralysis -

• weakness
• limited range of movement
• slow movement

• strained-strangled-harsh voice quality

• hypernasality

• slow rate

• consonant imprecision

Ataxic Dysarthria

Lesion:

Causes: viral infection, tumor, CVA, trauma, CP

Friedrich's ataxia -

Hallmark:

typical neuromuscular symptoms:

• inaccurate movements
• slow movements
• hypotonia

• imprecise consonants
• excess and equal stress
• irregular articulatory breakdowns

Hypokinetic Dysarthria

Lesion:

Causes: drug induced:

Parkinson's disease - caused by lack of the neurotransmitter dopamine in the basal ganglia

usually idiopathic
 
 

Parkinson's symptoms:

• bradykinesia
• festination
• shuffling gate
• retropulsion
• mask-like facies
• limited range of motion

perceptual characteristics

• monopitch
• monoloudness
• reduced stress
• imprecise consonants
• short rushes of speech

Hyperkinetic Dysarthria

Lesion:

Hallmark:

Two types: predominately quick and predominately slow

predominately quick:

Causes: Huntington's Disease/chorea:
 
 

Gilles de la Tourette's syndrome:
 
 

• quick involuntary movements
• variable muscle tone

• imprecise consonants
• variable rate and loudness
• harsh voice quality
• distorted vowels

Causes: infection, CVA, tumor

dystonia:
 
 

drug induced - tranquilizers

dyskinesia (e.g., tardive dyskinesia)

• twisting, writhing movements
• slowness
• hypertonia

• imprecise consonants
• strained-strangled-harsh voice quality
• irregular articulatory breakdowns
• monopitch and monoloudness

Mixed Dysarthrias

Spastic-flaccid: Amyotrophic Lateral Sclerosis (ALS)
 
 
 
 

Lesion:

typical neuromuscular symptoms:

• weakness
• slow movement
• limited range of movement

• imprecise consonants
• hypernasality
• harsh voice quality, often sounds wet
• slow rate
• short phrases

ataxic-hypokinetic-spastic: Wilson's disease
 
 
 
 

Lesion:

typical neuromuscular symptoms: vary by the systems involved

perceptual characteristics vary, but include:

• prosodic disruptions
• slow rate
• imprecise consonants
• irregular articulatory breakdowns

Assessment

purpose:

general focus:

3 types of assessment:

1. oral motor exam
 
 
 
 

2. formal assessment - Assessment of Intelligibility of Dysarthric Speech
 
 
 
 

3. questionnaires

additional assessment may look at respiratory, laryngeal function

Treatment

focus of treatment depends on:

(review point place system in book - very clear; also specific treatment goals)

In general, treatment focuses on:

1. behavioral changes

2. compensatory strategies

3. including conversational partners

Apraxia definition:
 
 
 
 

Lesion:

Characteristics:
 
 
 
 
 
 
 
 

Assessment
 
 
 
 
 
 

Treatment