Dysarthria
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]
Synonyms and keywords:
Overview
Historical Perspective
- The term dysarthria is derived from New Latin.
- 'Dys' means dysfunctional/impaired and 'arthr' means joint/vocal articulation.[1]
Classification
| Type of Dysarthria | Area of Lesion | Main Feature |
| Flaccid | Bilateral/unilateral lower motor neuron | Weakness, hyporeflexia, lack of normal muscle tone |
| Spastic | Bilateral upper motor neuron(UMN) | Weakness, hyperreflexia, hypertonicity |
| Unilateral UMN | Unilateral upper motor neuron | Weakness, reduced ROM, decreased fine motor control of tongue & lips |
| Ataxic | Cerebellum | Poorly coordinated movements of speech mechanism, scanning/drunken speech |
| Hyper-kinetic | Basal ganglia | Quick involuntary movements (hyperkinesis) |
| Hypo-kinetic | Basal ganglia | Less movement (hypokinesis), increased muscle tone |
| Mixed | More that one type of dysarthria co-exist | Mixed presentation |
Pathophysiology
- Dysarthria is a motor speech disorder, marked by poor articulation caused by neuromuscular impairment.[4]
- Neurological deficit in CNS and/or PNS causes weakness and/or paralysis of muscles responsible for speech.
- Following subsystems contribute to speech formation, impairment of these subsystems results into poor perceptual speech:[5]
Causes
| Pathology | Disease |
| Lower motor neuron | Myasthenia gravis, muscular dystrophy, cranial nerve VII, IX, X, XII, motor neuron disease |
| Upper motor neuron(UMN) | Stroke, Multiple sclerosis, amyotrophic lateral sclerosis, bilateral lacunar internal capsule strokes |
| Cerebellum | Spinal-Cerebellar Ataxia, multiple sclerosis, alcohol, tumor, paraneoplastic disorder |
| Basal ganglia | Parkinsonism |
| Toxic and metabolic | Wilson's disease, hypoxic encephalopathy, central pontine myelinolysis, botulism |
Differentiating Dysarthria from other Diseases
- Dysarthria must be differentiated from other motor speech disorders like apraxia and development verbal dyspraxia.
- Apraxia is a neurological disorder where there is ability and motivation to form speech but the patient cannot due to neurological deficit.
- Development verbal dyspraxia lacks muscle weakness and is characterized by developmental inability to motor plan volitional movement for the production of speech. Links to the FOXP2 gene have been identified.[6]
Epidemiology and Demographics
Risk Factors
Screening
Natural History, Complications, and Prognosis
Diagnosis
Treatment
The articulation problems that dysarthria causes can be treated together with a speech language pathologist using a range of techniques which sometimes includes strengthening the speech musculature. Devices that make coping with dysarthria easier include speech synthesis software and text-based telephones.
References
- ↑ "Definition of DYSARTHRIA". www.merriam-webster.com. Retrieved 2020-03-07.
- ↑ Duffy, Joseph R.; Josephs, Keith A. (2012). "The Diagnosis and Understanding of Apraxia of Speech: Why Including Neurodegenerative Etiologies May Be Important". Journal of Speech, Language, and Hearing Research. 55 (5). doi:10.1044/1092-4388(2012/11-0309). ISSN 1092-4388.
- ↑ 1459-Blanchet%20(1).pdf
- ↑ O'Sullivan, S. B.; Schmitz, T. J. (2007). Physical Rehabilitation (5th ed.). Philadelphia: F. A. Davis Company
- ↑ Mackenzie C (April 2011). "Dysarthria in stroke: a narrative review of its description and the outcome of intervention". Int J Speech Lang Pathol. 13 (2): 125–36. doi:10.3109/17549507.2011.524940. PMID 21480809.
- ↑ Duffy, J. R. (2013). Motor speech disorders (3rd ed.)St. Louis, MO: Elsevier Mosby.