Chapter 8 Hyperkinetic Dysarthria

Question 1

Subsystems affected by Hyperkinetic Dysarthria

Answer 1

All systems can be affected but primarily prosody

Question 2

Lesion sight for Hyperkinetic Dysarthria

Answer 2

Basal ganglia circuit (extrapyramidal tract)

Question 3

Key to Hyperkinetic Dysarthria

Answer 3

involuntary movements

• Hyper doesn’t mean fast, rather “extra”
• abnormal, rhythmic/irregular, unpredictable, rapid/slow movements

Question 4

Abnormal movements my be a result of

Answer 4

failure to inhibit cortical motor discharges or firing from the thalamus OR an imbalance between the excitatory (ACH) and inhibitory (Dopamine) neurotransmitters

Question 5

Etiologies

Answer 5

Many but mainly toxic-metabolic and idiopathic causes are most frequent

Question 6

Dyskinesia Categories

Answer 6

-Orofacial dyskinesias
-Tardive dyskinesia (antipsychotic drugs)
-akathisia (motor restlessness)
-Myoclonus (single brief mvmt)
-Tics
Chorea (random/rapid)
Ballism (abrupt large muscle contractions
-Athetosis (cant keep body part still)
-Dystonia (abnormal posture)
-Spasms
-Tremor

Question 7

Degenerative Etiologies

Answer 7

Huntington’s Chorea

Huntington’s Disease

Question 8

Toxic Metabolic Etiologies

Answer 8

Antipsychotic drugs

Question 9

Vascular Etiologies

Answer 9

Usually not seen unless they affect the basal ganglia or cerebellum

Question 10

Infectious Etiologies

Answer 10

inflammation can cause Sydenham’s Chorea from strep throat

Question 11

Neoplastic Etiologies

Answer 11

Tumors in the basal ganglia or thalamus

Question 12

Other Etiologies

Answer 12

Tourette’s

Question 13

Patient Complaints

Answer 13

• can’t keep jaw, face, tongue, still
• problems swallowing and chewing
• abnormal movements

Question 14

Signs associated with Chorea

Answer 14

• Motor unsteadiness
• unpredictable movements and -breakdown in prosody
• sudden forced breathing
• excess loudness variations
• strained-strangled voice
• voice stoppages
• transient breathiness
• intermittent hypernasality and weak pressure consonants
• irregular breakdowns, distortions, and distorted vowels (slow irregular AMRs)
• inappropriate silences
• variable rate and variable stress patterns
• prolonged phonemes

Question 15

Signed associated with Dystonia

Answer 15

• slower than chorea
• may have problems with drooling
• movement problems primarily at rest
• facial grimaces
• voice stoppages
• strained harsh voice
• audible inspirations
• excess loudness variations
• intermittent hypernasality
• irregular breakdowns, distortions, and distorted vowels (slow irregular AMRs)

Question 16

Signed associated with Spasmodic Dysphonia

Answer 16

• spasms in the laryngeal adductors or abductor muscles
• strained or breathy voice quality
• effortful speech results in fatigue