Adult Neuromotor Conditions

Question 1

What are neuromotor conditions?

Answer 1

Any condition affecting one or multiple speech processes brought about by damage to the nervous system

Question 2

What is apraxia of speech (AoS)? What is usually damaged?

Answer 2

• Neurogenic speech disorder characterized by problems in creating motor plans and/or sequencing moving muscles for producing speech
• In isolation, NO muscular weakness present
• Inconsistent articulatory errors; more apparent on longer utterances
• Usually present when damage is located on the frontotemporal region of the (L) hemisphere of the cerebrum

Question 3

What is dysarthria?

Answer 3

• Neurogenic speech disorder affecting respiration, phonation, prosody, resonance, and/or articulation due to problems with strength, mobility, and/or endurance
• Has different types that depend heavily on which part of the brain is damaged

Question 4

What is the difference between apraxia of speech and dysarthria?

Answer 4

AoS and Dysarthria may co-occur
- AoS has inconsistent errors while dysarthria usually has consistent errors
- Aos–the more complex, the more errors, while dysarthria complexity has no effect on errors
- In AoS, automatic speech has less errors, while with dysarthria automatic speech has no effect on errors
- AoS–repetition = fewer errors (however this may not be always true), while for dysarthria, repetition alone has no effect on errors

Question 5

Lesion site of this type of dysarthria (spastic)

Answer 5

Upper motor neuron (bilateral)

Question 6

What is the neurologic basis of spastic dysarthria

Answer 6

• Weakness
• Spasticity

Question 7

Speech characteristics of a person with spastic dysarthria

Answer 7

• Articulation - imprecise consonants, distorted vowels
• Prosody - slow rate, reduced stress
• Phonation - hyperadduction of vocal folds, breathy, hoarse, pitch breaks, mono pitch/loudness

Question 8

Lesion site for flaccid dysarthria

Answer 8

LMN

Question 9

Neurological basis for flaccid dysarthria

Answer 9

• Weakness
• Hypotonia

Question 10

Speech characteristics of flaccid dysarthria

Answer 10

• Articulation - weak pressure consonants
• Prosody - short phrases
• Phonation - breathy, monopitch, hoarse
• Resonance - nasal emission, hypernasal
• Respiration - weak subglottic pressure → breathy voice

Question 11

Lesion site for hypokinetic dysarthria

Answer 11

Basal ganglia or basal ganglia connection within CNS (Parkinson’s disease)

Question 12

Neurologic basis for hypokinetic dysarthria

Answer 12

• Reduced range of movement, rigidity, reduced movement (hypo-less or reduced movements)

Question 13

Speech characteristics of hypokinetic dysarthria

Answer 13

• Articulation - imprecise/distorted consonants
• Prosody - short rushes of speech, increased rate in segments of utterances, “stuttering”
• Phonation - monopitch, low vocal loudness

Question 14

Lesion site of hyperkinetic dysarthria

Answer 14

Basal ganglia or basal ganglia connection within CNS (Huntington’s diseases, Syndenham’s Chorea)

Question 15

Neurologic basis of hyperkinetic dysarthria

Answer 15

• Abnormal, extra movements
• “Hyper” - more movements

Question 16

Speech characteristics of hyperkinetic dysarthria

Answer 16

• Articulation - imprecise consonants, distorted vowels
• Prosody - slower rate of speech, prolonged interword intervals, inappropriate silent periods, excess/equal stress
• Phonation - difficulty varying pitch/loudness
• Respiration - audible inspiration, sudden inspiration/expiration

Question 17

Lesion site of ataxic dysarthria

Answer 17

Cerebellum

Question 18

Neurologic basis of ataxic dysarthria

Answer 18

Incoordination

Question 19

Speech characteristics of ataxic dysarthria

Answer 19

• Articulation – irregular articulatory errors, imprecise consonants, distortion of vowels
• Respiration – exaggerated inhalation/exhalation, mistimed breathing during speech
• Prosody – excessive stress, prolonged phonemes and intervals between words or syllables (“drunken speech”), slow rate of speech

Question 20

Lesion site of unilateral upper motor neuron

Answer 20

UMN (unilateral)

Question 21

Neurologic basis of Unilateral upper motor neuron

Answer 21

• Weakness, spasticity

Question 22

Speech characteristics of unilateral upper motor neuron

Answer 22

Phonation – hoarseness, reduced loudness, monopitch, monoloudness (very hoarse)
Other areas similar to spastic dysarthria

Question 23

Lesion site of mixed dysarthria

Answer 23

Damage to various parts of the nervous systems (neurodegenerative diseases)

Question 24

Sample mixed dysarthria and conditions

Answer 24

• Flaccid-spastic (ALS–Amyotrophic lateral sclerosis )
• Ataxic-spastic (MS–multiple sclerosis → attacks the spine or brain)
• Flaccid (GB–Guillain-Baré syndrome → attacks the PNS)*
• Mild dysarthria (MG–myasthenia gravis)*

Question 25

Speech characteristics of mixed dysarthria

Answer 25

Depends on the affected parts of the nervous system