Dysarthria

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Dysarthria
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Overview

Overview

Dysarthria is a neurological condition where the muscles used for speech are weak or become difficult to control due to injury or damage to the nerves that innervate these muscles. It should not be confused with the condition apraxia which is difficulty in speech caused by anatomical issues such as a cleft palate, for example.

The affected areas of the nervous system include the central and peripheral nervous systems, and the cranial nerves including trigeminus, facialis, glossopharyngeus, vagus and hypoglossus.

Complications of dysarthria include social isolation and depression in some affected individuals, and may make relationships with friends and family difficult due to the communication problems they face.

Etiology

Causes of dysarthria include condition that injure or damage the parts of the central nervous system involved with innervations of the muscles that control speech.

These include strokes, brain injury, Parkinson’s disease, myasthenia gravis, multiple sclerosis, Huntington’s disease, amyotrophic lateral sclerosis (ALS), cerebral palsy, and Lyme disease.

Signs and symptoms

Dysarthrias can be classified in numerous ways depending on where the lesion causing the nerve damage affecting speech occurs. The different dysarthrias include spastic (bilateral damage to upper motor neurons), flaccid (bilateral or one-sided damage to lower motor neurons), ataxic (cerebellar damage), and unilateral upper motor neuron type (a milder presentation compared to the spastic type).

In general, signs and symptoms of dysarthria include the following:

  • Slow and/or slurred speech.
  • Rapid speech that is difficult to understand.
  • Difficulty in moving the facial muscles or the tongue.
  • Inability to speak louder than a whisper, or to speak loudly.
  • Abnormal speech rhythm.
  • Strained, raspy or nasal sounding voice.
  • Monotonous speech.
  • Uneven speech volume.

Diagnosis

The diagnosis of dysarthria is based on the findings made on the medical history and clinical examination of the affected patient. Speech/language therapists can be asked to give their opinion on a patient where they will help to confirm the diagnosis.

The physician will then investigate further to determine the cause of the dysarthria, and may request certain special investigations to do so. These may include blood and urine tests to look for generalized infections and inflammatory conditions, a lumbar puncture to rule out infections of the cerebrospinal fluid and inflammatory conditions of the central nervous system, imaging tests such as CT scans and MRIs to rule out lesions and tumors, brain and nerve studies to monitor electrical activities in the brain and peripheral nerves, and a brain biopsy if a tumor in the organ is suspected or to analyze the brain tissue.

Management

Managing dysarthria will depend on the cause and severity of the condition. The cause of the dysarthria will be diagnosed and managed by the patient’s physician, and this may improve their speech.

Patients with dysarthria will be referred to a speech/language therapist who will suggest various communication methods to help the affected individual communicate. These methods include alternative and augmentative communication systems. If verbal communication cannot be improved, then other methods of communication can be taught such as using gestures, visual cues, sign-language, an alphabet-board, and even computer-based technology similar to that used by Dr. Stephen Hawking.