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ECU Motor Speech Disorders > 7.2 - Hyperkinetic Dysarthria > Flashcards

7.2 - Hyperkinetic Dysarthria Flashcards

1
Q

What is the hallmark of Hyperkinetic Dysarthria?

A

Involuntary movement

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2
Q

What is seen in Range of Movement in Hyperkinetic Dysarthria?

A

More movement or less movement

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3
Q

What is seen in Velocity of Movement in Hyperkinetic Dysarthria?

A

Fast movement or slow movement

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4
Q

What is seen in Direction of Movement in Hyperkinetic Dysarthria?

A

Abnormal

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5
Q

What is seen in Accuracy of Movement in Hyperkinetic Dysarthria?

A

Interferes with speech (or may not)

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6
Q

How is Strength of Movement in Hyperkinetic Dysarthria?

A

Ok

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7
Q

What is seen in Timing of Movement in Hyperkinetic Dysarthria?

A

Fast movement or slow movement

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8
Q

What is seen in Muscle Tone in Hyperkinetic Dysarthria?

A

Depends

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9
Q

What is seen in Coordination of Movement in Hyperkinetic Dysarthria?

A

Involuntary movement interferes with background coordination

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10
Q

What is the key concept in Hyperkinetic Dysarthria?

A

It is involuntary

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11
Q

What is most affected in Hyperkinetic Dysarthria?

A

Prosody

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12
Q

What might Hyperkinetic Dysarthria interfere with?

4

A

Respiration

Phonation

Articulation

Resonance

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13
Q

What do the effects of Hyperkinetic Dysarthria depend on?

3

A

Type of involuntary movement

Whether lesions are uni-focal or multi-focal

Muscle(s) affected

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14
Q

What is the Pathophysiology of Hyperkinetic Dysarthria?

5

A

Injury or malfunction of indirect motor system (extrapyramidal and cerebellar)

Failure to inhibit cortical motor discharges

Loss of neurons in extrapyramidal sys.

Neurotransmitter disequilibrium

Interference with thalamocortical pathways

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15
Q

What
symptoms are seen in Hyperkinetic Dysarthria?

(10)

A

Hyperkinesia

Dyskinesia

Myoclonus

Tics (fast)

Chorea (fast)

Ballism (fast)

Athetosis

Dystonia (slow)

Spasm (fast or slow)

Tremor

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16
Q

What types of Hyperkinesia (movement disorder) are seen in Hyperkinetic Dysarthria?

(3)

A

Involuntary

Slow or fast

Rhythmic or irregular

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17
Q

What is Dyskinesia (fast or slow)?

A

Abnormal, involuntary movements, regardless of etiology

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18
Q

What are 3 types of Dyskinesia?

A

Orofacial dyskinesias (mouth, face, tongue, jaw)

Tardive dyskinesia (drug-induced)

Akathisia (subjective, motor restlessness)

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19
Q

Does Dyskinesia affect speech?

A

Not directly but trying to control movement may be distracting

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20
Q

What is Myoclonus (fast or slow)?

Where is it seen?

A

Involuntary single or repetitive brief jerks of a body part

Isolated or multiple muscle groups

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21
Q

What might stimulate Myoclonus?

3

A

None

Visual, tactile auditory

Movement (“action myoclonus”)

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22
Q

What causes Myoclonus?

A

Palatal myoclonus (brainstem lesion)

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23
Q

What is a commonly seen type of Myoclonus?

A

Hiccups: brief spasm of diaphragm with subsequent adduction of the vocal cords

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24
Q

What can cause chronic Hiccups?

2

A

Toxic-metabolic conditions

Lesions of the medulla

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25
What are Tics (fast)?
Rapid, stereotyped movements
26
What are the two kinds of Tics?
Simple (similar to myoclonus) Complex: coordinated (e.g., jumping)
27
What are examples of Complex Tics? | 5
Jumping Noises Coprolalia (involuntary and repetitive use of obscene language) Lip smacking Touching
28
What is Chorea (fast)?
Rapid, involuntary, random movements
29
When can Chorea be seen? | 3
At rest During sustained postures During voluntary movement
30
What causes Chorea? | 6
Inflammation Infection Degeneration Toxic- metabolic Vascular Idiopathic
31
Chorea tends to affect _______ but it can affect _______.
One body part Multiple
32
What are Ballism (fast)?
Gross, abrupt contractions
33
Where can Ballism be seen? | 3
Extremities “Flailing” Bilateral or unilateral (hemiballismus)
34
What causes Ballism?
Subthalamic lesions
35
What is Athetosis? | 3
Slow movement Inability to maintain a body part Superimposed slow, writhing movements
36
When is Athetosis seen in Children? What is it typically referred to as?
Cerebral palsy Athetosis
37
What is Athetosis in Adults (acquired) usually referred to as?
Dystonia
38
What is Dystonia (slow)? | 2
Abnormal postures Excessive co-contraction of antagonistic muscles
39
What are the two kinds of Dystonia?
General Focal (segmental)
40
What are 4 examples of Dystonia?
Orofacial dystonia Writer’s cramp Blepharospasm (involuntary blinking) Spasmodic torticollis (lat, retro, antero)
41
What are 3 types of Spasms (fast or slow)?
Tonic spasm Clonic spams Hemifacial spasm
42
What are Tonic Spasms?
Slow, prolonged or continuous
43
What are Clonic Spams?
Repetitive, rapid, brief
44
What is a Tremor?
Rhythmic movement
45
What are the 4 main types of Tremor?
Resting Postural Action Terminal
46
What are 6 examples of Tremor?
Physiologic tremor Exaggeration of normal tremor (10-12Hz) Toxic tremor Essential tremor (postural or action) Cerebellar tremor (postural, action, terminal) Wing-beating tremor (postural, proximal)
47
What do patients complain about in Hyperkinetic Dysarthria? | 5
Depends on the type of movement disorder and the level of the speech system it affects If Jaw, face, tongue affected – slurred, slow, halting speech (Words are hard to get out) Chewing and swallowing difficulty Shortness of breath Physical exhaustion
48
What causes Hyperkinetic Dysarthria? | 5
Degenerative illness Toxic-metabolic Vascular disorders Infections Tumors
49
What 2 Degenerative Illnesses can cause Hyperkinetic Dysarthria?
Huntington’s chorea Primary generalized dystonia
50
What is Huntington’s Chorea? When does it usually begin?
Basal ganglia malfunction Starts in middle-age
51
What signs are seen in Huntington's Disease? | 4
Behavior issues Memory issues Fast decline Early onset (30-40) [First two are earliest symptoms]
52
What is Primary Generalized Dystonia (Dystonia muscular deformans)? When does it begin?
Genetic disorder Starts in childhood
53
What can create Toxic-Metabolic causing Hyperkinetic Dysarthria? (3)
Antipsychotic drugs Dopaminergic drugs Anticonvulsants [E.g., tardive dyskinesia (neuroleptic use, e.g., schizophrenia)]
54
What other illnesses can cause Hyperkinetic Dysarthria? | 3
Meige Syndrome Gilles de la Tourette Chorea Gravidarium
55
What 3 things are seen in Meige Syndrome?
Focal cranial dystonia Blepharospasm Oromandibular dystonia
56
What 2 things are seen in Gilles de la Tourette?
Motor and vocal tics Coprolalia (scatological language)
57
What causes Chorea Gravidarium? Is it permanent?
Pregnancy in women w/rheumatic heart disease No, it resolves
58
How is Prosody affected in Hyperkinetic Dysarthria? | 3
Prolonged intervals Variable rate Excess loudness variation
59
How is Naturalness affected in Hyperkinetic Dysarthria?
Not at all
60
How is Phonation affected in Hyperkinetic Dysarthria? | 3
Breathiness Short phrases Audible inspiration
61
How is Resonance affect in Hyperkinetic Dysarthria? | 4
Hypernasality Imprecise consonants Nasal emission Short phrases
62
What Phonatory-Prosodic affects are seen in Hyperkinetic Dysarthria? (3)
Harsh voice Monoloudness Monopitch
63
What 2 clinical tests can be used to discover Hyperkinetic Dysarthria?
Oral-facial examination Speech systems screening
64
What are the 3 most useful clinical tests for diagnosing Hyperkinetic Dysarthria?
/a/ AMRs and SMRs Connected speech (Note that Hyperkinetic Dysarthria may not affect speech)

ECU Motor Speech Disorders (16 decks)

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