Disorders Of Speech Dysarthria

DIAGNOSTIC APPROACH

Listen to spontaneous speech and ask the patient to read aloud.

Observe: lingual consonants - 'ta ta ta' (made with the tongue), labial consonants - 'mm mm mm' (made with the lips), guttural consonants - 'ga ga ga' (laryngeal and pharyngeal/ palatal). Difficulty with articulation = DYSARTHRIA

N.B. Beware misinterpretation of dialect or poorly fitting teeth.

Speech hoarse and strained; labial consonants ^

especially affected.

Speech slow and monotonous with abnormal separation of syllables -'scanning speech'; at — times may sound explosive -Associated signs of cerebellar disease

Soft and monotonous with — poor volume and little inflection -and short rushes of speech

Associated — contralateral hemisparesis or dysphasia

Other signs of pseudobulbar palsy (impaired chewing, -

swallowing)

ATAXIC DYSARTHRIA

SPASTIC DYSARTHRIA (Cortical origin)

SPASTIC DYSARTHRIA (Cortical origin)

SPASTIC DYSARTHRIA (Corticobulbar origin)

ATAXIC DYSARTHRIA

SPASTIC DYSARTHRIA (Corticobulbar origin)

Associated signs of extrapyramidal disease

Labial consonants -first affected, later gutturals. Nasal speech and progression to total loss of articulation (ianarthria). Associated signs of l.m.n. weakness of X and XII

(Lesion in cerebellar vermis and paravermis)

HYPOKINETIC (slow)

HYPER-KINETIC (fast) DYSARTHRIA (Lesion of the extrapyramidal system)

FLACCID DYSARTHRIA

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