Chapter 5 Spastic Dysarthria Flashcards
Spastic Dysarthria
Caused by damage to direct&indirect pathways, bilateral UMN lesions that affect all subsystems and is characterized primarily with spasticity
Which subsystems does Spastic Dysarthria affect?
All: respiratory, phonatory, resonatory, and articulatory
Spastic Dysarthria may also be known as:
Pseudobalbar palsy
Spasticity
muscles are weak and hard to move
slow and decreased range of motion
Spasticity means increased muscle tone/hyperactivity of muscle contraction which caused resistance to muscle movement
UMN system lesions cause:
Weakness loss of skilled movements decreased tone hypertonia babinski reflex abnormal sucking, snoutm and jaw jerk reflexes
Etiologies
Vascular diseases inflammatory diseases degenerative diseases toxic/metabolic diseases ANYTHING that can affect the direct/indirect pathways
Vascular Etiologies
Usually must have bilateral lesions in the cortex or single lesion at the brainstem
Lacunar infarcts
Binswanger’s subcortical encephalopathy
Inflammatory Etiologies
Leukoencephalitis (inflammation of white matter of the brain)
Degenerative Etiologies
Primary Lateral Sclerosis (PLS) ALS is a subcategory of PLS but in PLS there are only signs of UMN damage while ALS has mixed UMN/LMN damage
Patient Complaints
Slow or effortful speech Fatigue (myasthenia gravis) Patient perceived nasal speech difficulty swallowing drooling difficulty controlling their emotions (pseudobalbar affect)
Prominent Speech Characteristics
Strained-strangled voice quality
hypernasality (slow moving palate)
imprecise articulations (restricted movements)
slow rate (slow but regular AMRs)
Non-speech Clinical Findings
Dysphagia & nasal regurgitation Drooling Face may have fixed posture Hyperactive gag reflex Emotional lability Symmetrical weakness and slowness of tongue/face/palate
