chapter 9 Flashcards
definition of hyperkinetic dysarthria
dysfunction in basal ganglia, all produce involuntary movements that interfere with normal speech production
hyperkinetic means
too much movement
neurologic basis of hyperkinetic dysarthria
many disorders that cause hyperkinetic dysarthria associated with damage to basal ganglia
what causes hyperkinetic movement
basal ganglia not well understood, complex mechanism within basal ganglia not well understood
causes of hyperkinetic dysarthria
chorea, myoclonus, tics, essential tremor, dystonia, degenerative diseases, TBI, stroke, and infections
chorea
movement disorder distingushed by random involuntary movements of limbs, trunk, head, and neck
choreatic motions
appear fancelike, smooth and coordinated, but actually unpredictable, purposeless, and sometimes herky or abrupt
sydenham’s chorea
rare disorder affecting children after rheumatic fever
huntington’s disease
progressive inherited disorder
stroke
rare for stroke to cause chorea
tardive dyskinesia
caused by taking certain antipsychotics for a prolonged duration
speech characteristics of hyperkinetic dysarthria of chorea
degree of chorea influences how severely speech is affected
distinctive errors of hypokinetic dysarthria of chorea
variable in speech rate, inappropriate silences, excess loudness variations, prolonged phonemes, rapid, brief inhaltions or exhalations of air voice stoppages,
myoclonus
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
tic disorders
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
essential tremor
benign hyperkinetic movement disorder that causes tremulous movements in affected body parts, idiopathic, most common hyperkinetic movement disorder
dystonia
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
disorders that have dystonia as a characteristic
spasmodic torticollis, drug-induced dystonia, meige syndrome, spasmodic dysphonia
speech characteristics of hyperkinetic dysarthria of dystonia
-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
key evaluation tasks for hyperkinetic dysarthria
vowel prolongation, AMRs, conversational speech and reading, careful observation of associated involuntary movements
treatment of hyperkinetic dysarthria
diverse treatment options, based on medical or behavioral interventions
medical treatments
-pharmacologic: drugs that suppress involuntary movements that cause speech deficits
-botox: most successful
-deep brain stimulation
behavioral treatment for huntington’s disease
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
behavioral treatment for dystonia
sensory tricks: idiosyncratic strategies that can supress involuntary movement for a time
bite blocks: to stablilize jaw during speech
easy onset of phonation
behavioral treatment for tic disorders
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
