chapter 9

Question 1

definition of hyperkinetic dysarthria

Answer 1

dysfunction in basal ganglia, all produce involuntary movements that interfere with normal speech production

Question 2

hyperkinetic means

Answer 2

too much movement

Question 3

neurologic basis of hyperkinetic dysarthria

Answer 3

many disorders that cause hyperkinetic dysarthria associated with damage to basal ganglia

Question 4

what causes hyperkinetic movement

Answer 4

basal ganglia not well understood, complex mechanism within basal ganglia not well understood

Question 5

causes of hyperkinetic dysarthria

Answer 5

chorea, myoclonus, tics, essential tremor, dystonia, degenerative diseases, TBI, stroke, and infections

Question 6

chorea

Answer 6

movement disorder distingushed by random involuntary movements of limbs, trunk, head, and neck

Question 7

choreatic motions

Answer 7

appear fancelike, smooth and coordinated, but actually unpredictable, purposeless, and sometimes herky or abrupt

Question 8

sydenham’s chorea

Answer 8

rare disorder affecting children after rheumatic fever

Question 9

huntington’s disease

Answer 9

progressive inherited disorder

Question 10

stroke

Answer 10

rare for stroke to cause chorea

Question 11

tardive dyskinesia

Answer 11

caused by taking certain antipsychotics for a prolonged duration

Question 12

speech characteristics of hyperkinetic dysarthria of chorea

Answer 12

degree of chorea influences how severely speech is affected

Question 13

distinctive errors of hypokinetic dysarthria of chorea

Answer 13

variable in speech rate, inappropriate silences, excess loudness variations, prolonged phonemes, rapid, brief inhaltions or exhalations of air voice stoppages,

Question 14

myoclonus

Answer 14

hyperkinetic movement disorder distingushed by involuntary and brief contractions of part, whole, or group of muscles in same area: muscle contractions may appear singly, in repeating irregular pattern, or rhythmically

Question 15

tic disorders

Answer 15

tics - rapid movement that can be controlled voluntarily for a time, but performed frequently due to compulsive desire; cause traced to mild brain damage or toxic reactions to medications in some cases, but no identifiable CNS disorder in most cases

Question 16

essential tremor

Answer 16

benign hyperkinetic movement disorder that causes tremulous movements in affected body parts, idiopathic, most common hyperkinetic movement disorder

Question 17

dystonia

Answer 17

hyperkinetic movement disorder of muscle tone; causes involuntary, prolonged muscle contractions that interfere with normal movement or posture; slower, more sustained quality than seen in chorea, with contractions that wax and wane during ongoing movement

Question 18

disorders that have dystonia as a characteristic

Answer 18

spasmodic torticollis, drug-induced dystonia, meige syndrome, spasmodic dysphonia

Question 19

speech characteristics of hyperkinetic dysarthria of dystonia

Answer 19

-articulation: imprecise consonants, distorted vowels, irregular articulatory breakdowns, prolonged phonemes
-prosody: monopitch, monoloudness, inappropriate silences, shortened phrases
-phonation: harsh vocal quality, strained-strangled quality, excess loudness variation
-respiration and resonance - less impacted

Question 20

key evaluation tasks for hyperkinetic dysarthria

Answer 20

vowel prolongation, AMRs, conversational speech and reading, careful observation of associated involuntary movements

Question 21

treatment of hyperkinetic dysarthria

Answer 21

diverse treatment options, based on medical or behavioral interventions

Question 22

medical treatments

Answer 22

-pharmacologic: drugs that suppress involuntary movements that cause speech deficits
-botox: most successful
-deep brain stimulation

Question 23

behavioral treatment for huntington’s disease

Answer 23

early stages: maintain normal prosody and optimal rate
middle: rate of speech, rhythmic breathing and relaxation, speaking on exhalation
progressive dementia: work closely with caregivers

Question 24

behavioral treatment for dystonia

Answer 24

sensory tricks: idiosyncratic strategies that can supress involuntary movement for a time
bite blocks: to stablilize jaw during speech
easy onset of phonation

Question 25

behavioral treatment for tic disorders

Answer 25

behavioral treatments have been effective in some cases, habit reversal training, relaxation therapy may be helpful when combined with other treatment procedures, exposure response prevention, comprehensive behavioral intervention for tics