Dysarthria

Question 1

What are the different subsets of dysarthria? x6

Answer 1

1. Spastic dysarthria
2. Hypokinetic dysarthria
3. Ataxic dysarthria
4. Flaccid dysarthria
5. Hyperkinetic dysarthria
6. Unilateral Upper Motor Neuron (UUMN) lesion

Question 2

What is the site of lesion and related aetiology for hypokinetic dysarthria?

Answer 2

Basal ganglia control circuit
Related to Parkinson’s Disease, Vascular parkinsonism

Question 3

What are the characteristics of hypokinetic dysarthria?

Answer 3

• ‘Too little movement’
• Reduced facial expression
• Resting tremor of lips, jaw and tongue
• Bradykinesia (slow movement)
• Akinesia (inability to voluntary move)
• Rigidity
• Sensory-perceptual deficits

Question 4

What are the effects on speech regarding hypokinetic dysarthria?

Articulation, resonance, phonation, respiration, prosody?

Answer 4

*Articulation: imprecise consonants, palilia
*Resonance: mild hypernasality
*Phonation: harsh or breathy voice, low volume and pitch
*Respiration: shallow breathing resulting in reduced number of words per breath
*Prosody: monopitch, monoloudness, reduced stress, short rushes of speech, inappropriate silences, variable rate

Question 5

What is the site of lesion and related aetiology for hyperkinetic dysarthria?

Answer 5

Site of lesion: basal ganglia control circuit, damage caused to cerebellar control circuit and brainstem structures

Main aetiologies: Huntington’s Disease, brainstem stroke, Tourette’s syndrome, tardive dyskinesia, spasmodic dysphonia, essential tremor

Question 6

What are some characteristics of hyperkinetic dysarthria?

Answer 6

*‘Too much movement’
*Normal speech is interfered with abnormal involuntary movements that interrupt/slow down speech
*Abnormal movements: rhythmic or irregular, predictable or unpredictable, fast or slow

Question 7

What are the effects on speech regarding hyperkinetic dysarthria?

Articulation, resonance, phonation, respiration, prosody?

Answer 7

*Articulation: variable articulatory imprecision
*Resonance: usually normal but occasional hypernasality
*Phonation: voice stoppages, strained/breathy voice
Respiration: unexpected inhalations and exhalations results in short utterances
*Prosody: excessive variation loudness, variable rate and pitch, prolonged intervals between words and syllables, inappropriate silences, prolonged phonemes

Question 8

What is the site of lesion and related aetiology for ataxic dysarthria?

Answer 8

Site of lesion: cerebellar control circuit

Main aetiologies: stroke, TBI, Friedrich’s Ataxia

Question 9

What are the characteristics of ataxic dysarthria?

Answer 9

*Reduced control of motor movements
*Poorly timed and uncoordinated movements
*‘Drunken’ speech quality

Question 10

What are the effects on speech regarding ataxic dysarthria?

Articulation only

Answer 10

Articulation: imprecise consonants, irregular articulatory breakdowns, distorted vowels, more apparent in multisyllabic words, prolonged phonemes

Question 11

What are the effects on speech regarding ataxic dysarthria?

Resonance and phonation only

Answer 11

Resonance - intermittent hyponasality

Phonation - harsh vocal or vocal tremor

Question 12

What are the effects on speech regarding ataxic dysarthria?

Respiration only

Answer 12

Uncoordinated breathing patterns, short phrases, loudness variation

Question 13

What are the effects on speech regarding ataxic dysarthria?

Prosody only

Answer 13

Excess and equal stress, prolonged intervals between syllables and words, slow rate of speech, monopitch, monoloudness or excessive variation

Question 14

What is the site of lesion and related aetiology for spastic dysarthria?

Answer 14

Site of lesion: bilateral upper motor neuron damage

Aetiologies: stroke (in both brain hemispheres), TBI, degenerative disease, cerebral palsy

Question 15

What are the characteristics regarding spastic dysarthria?

Answer 15

*Difficulty initiating movement
*Muscle weakness
*Slowness of movement
*Spasticity/excessive muscle tone and overactive reflexes
*Reduced range of movement

Question 16

What are the effects on speech regarding spastic dysarthria?

Answer 16

*Articulation: imprecise consonants, distorted vowels, prolonged phonemes
*Resonance: hypernasality
*Phonation: stenosis, strangled/strangled voice, low pitch, harshness, pitch breaks
*Prosody: excess, equal or reduced stress, slow rates, short phrases, monopitch, monoloudness

Question 17

What is the site of lesion and related aetiology for unilateral upper motor neuron (UUMN) dysarthria?

Answer 17

Site of lesion: damage to the upper motor neuron on one side of the brain

Aetiology: stroke (in one brain hemisphere)

Question 18

What are the characteristics of unilateral upper motor neuron (UUMN) dysarthria?

Answer 18

*Lack of speech changes
*Weakness on one side of the lower face and lips, flattened nasolabial fold, corner of the mouth droops
*Weakness on one side of the tongue?

Question 19

Why is there a lack of speech changes regarding UUMN dysarthria?

Answer 19

The vast majority of cranial nerves are bilaterally inverted.
Damage is only on one side of the brain.

Question 20

What are the effects on speech regarding UUMN dysarthria?

Answer 20

Articulation: imprecise labial and lingual phonemes
Prosody: slow rate, vocal quality, pitch and resonance may be affected

Question 21

What is the site of lesion and related aetiology for flaccid dysarthria?

Answer 21

Site of lesion: bilateral or unilateral damage to the lower motor neurons

Aetiology: MND, multiple systems atrophy, brainstem stroke, muscular dystrophy etc.

Question 22

What are the characteristics regarding flaccid dysathria?

Answer 22

*Muscle weakness, reduced tone, diminished reflexes
*Can be present with atrophy and fasciculations
*Floppy muscles
*Muscles rapidly weaken over time then recover after resting

Question 23

What is the effect on speech regarding flaccid dysarthria?

Articulation, resonance, phonation, respiration, prosody?

Answer 23

*Articulation: imprecise consonants (depending on which cranial nerve is damaged)
*Resonance: hypernasality, nasal emission
*Phonation: incomplete adduction of the vocal folds, breathy/harsh voice
*Respiration: weak respiration muscles, audible inspiration, low volume, reduced number of words per breath
*Prosody: monopitch, monoloudness, low volume, slow rate