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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
Q

What are Tics (fast)?

A

Rapid, stereotyped movements

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26
Q

What are the two kinds of Tics?

A

Simple (similar to myoclonus)

Complex: coordinated (e.g., jumping)

27
Q

What are examples of Complex Tics?

5

A

Jumping

Noises

Coprolalia (involuntary and repetitive use of obscene language)

Lip smacking

Touching

28
Q

What is Chorea (fast)?

A

Rapid, involuntary, random movements

29
Q

When can Chorea be seen?

3

A

At rest

During sustained postures

During voluntary movement

30
Q

What causes Chorea?

6

A

Inflammation

Infection

Degeneration

Toxic- metabolic

Vascular

Idiopathic

31
Q

Chorea tends to affect _______ but it can affect _______.

A

One body part

Multiple

32
Q

What are Ballism (fast)?

A

Gross, abrupt contractions

33
Q

Where can Ballism be seen?

3

A

Extremities

“Flailing”

Bilateral or unilateral (hemiballismus)

34
Q

What causes Ballism?

A

Subthalamic lesions

35
Q

What is Athetosis?

3

A

Slow movement

Inability to maintain a body part

Superimposed slow, writhing movements

36
Q

When is Athetosis seen in Children?

What is it typically referred to as?

A

Cerebral palsy

Athetosis

37
Q

What is Athetosis in Adults (acquired) usually referred to as?

A

Dystonia

38
Q

What is Dystonia (slow)?

2

A

Abnormal postures

Excessive co-contraction of antagonistic muscles

39
Q

What are the two kinds of Dystonia?

A

General

Focal (segmental)

40
Q

What are 4 examples of Dystonia?

A

Orofacial dystonia

Writer’s cramp

Blepharospasm (involuntary blinking)

Spasmodic torticollis (lat, retro, antero)

41
Q

What are 3 types of Spasms (fast or slow)?

A

Tonic spasm

Clonic spams

Hemifacial spasm

42
Q

What are Tonic Spasms?

A

Slow, prolonged or continuous

43
Q

What are Clonic Spams?

A

Repetitive, rapid, brief

44
Q

What is a Tremor?

A

Rhythmic movement

45
Q

What are the 4 main types of Tremor?

A

Resting

Postural

Action

Terminal

46
Q

What are 6 examples of Tremor?

A

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
Q

What do patients complain about in Hyperkinetic Dysarthria?

5

A

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
Q

What causes Hyperkinetic Dysarthria?

5

A

Degenerative illness

Toxic-metabolic

Vascular disorders

Infections

Tumors

49
Q

What 2 Degenerative Illnesses can cause Hyperkinetic Dysarthria?

A

Huntington’s chorea

Primary generalized dystonia

50
Q

What is Huntington’s Chorea?

When does it usually begin?

A

Basal ganglia malfunction

Starts in middle-age

51
Q

What signs are seen in Huntington’s Disease?

4

A

Behavior issues

Memory issues

Fast decline

Early onset (30-40)

[First two are earliest symptoms]

52
Q

What is Primary Generalized Dystonia (Dystonia muscular deformans)?

When does it begin?

A

Genetic disorder

Starts in childhood

53
Q

What can create Toxic-Metabolic causing Hyperkinetic Dysarthria?

(3)

A

Antipsychotic drugs

Dopaminergic drugs

Anticonvulsants

[E.g., tardive dyskinesia (neuroleptic use, e.g., schizophrenia)]

54
Q

What other illnesses can cause Hyperkinetic Dysarthria?

3

A

Meige Syndrome

Gilles de la Tourette

Chorea Gravidarium

55
Q

What 3 things are seen in Meige Syndrome?

A

Focal cranial dystonia

Blepharospasm

Oromandibular dystonia

56
Q

What 2 things are seen in Gilles de la Tourette?

A

Motor and vocal tics

Coprolalia (scatological language)

57
Q

What causes Chorea Gravidarium?

Is it permanent?

A

Pregnancy in women w/rheumatic heart disease

No, it resolves

58
Q

How is Prosody affected in Hyperkinetic Dysarthria?

3

A

Prolonged intervals

Variable rate

Excess loudness variation

59
Q

How is Naturalness affected in Hyperkinetic Dysarthria?

A

Not at all

60
Q

How is Phonation affected in Hyperkinetic Dysarthria?

3

A

Breathiness

Short phrases

Audible inspiration

61
Q

How is Resonance affect in Hyperkinetic Dysarthria?

4

A

Hypernasality

Imprecise consonants

Nasal emission

Short phrases

62
Q

What Phonatory-Prosodic affects are seen in Hyperkinetic Dysarthria?

(3)

A

Harsh voice

Monoloudness

Monopitch

63
Q

What 2 clinical tests can be used to discover Hyperkinetic Dysarthria?

A

Oral-facial examination

Speech systems screening

64
Q

What are the 3 most useful clinical tests for diagnosing Hyperkinetic Dysarthria?

A

/a/

AMRs and SMRs

Connected speech

(Note that Hyperkinetic Dysarthria may not affect speech)

ECU Motor Speech Disorders (16 decks)

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