Dysarthria/Dysphagia Flashcards
What are Dysarthria/Dysphagia sx caused by?
Weakness of oropharyngeal muscles
Where do CN controlling speech & swallowing originate?
Medulla
(except CN VII)
What are the sx of myopathy?
- Difficulty articulating speech or swallowing or both
- Onset gradual
- No sensory complaint
- Symmetrical
What are the PE findings of myopathy?
- Gag reflex intact
- Symmetrical & proximal weakness
- Sx do not wax/wane
- Normal DTRS
What are the tech features of myopathy?
- +/- inc CPK
- +/- genetic testing
- +/- thyroid function ABN
- Ach receptor Ab negative
What is the hx of Progressive Bulbar Palsy?
Older age group
Gradual onset
What are the PE findings of Progressive Bulbar Palsy?
- Dysarthria/dysphagia
- Dec gag reflex
- Atrophy & fasiculations of tongue
- Late course may turn into typical ALS
What is the cause of Progressive Bulbar Palsy?
Variant of Motor Neuron dz or ALS
What is the tx for Progressive Bulbar Palsy?
- Dietary modification
- Speach & swallow therapy
- Eventually feeding tube required
What is the hx of Pseudobulbar Palsy?
- Dysarthria/dysphagia
- Emotionaly labile w/ spon bursts of laughter or crying
- Hx of multiple small strokes
- Hx of falls
- Vascular RF
- Younger adults–MS
What are the PE findings of Pseudobulbar palsy?
- MC bilateral UMN signs (freq unilateral)
- Frontal release signs
- No atrophy of tongue
- Gag reflex usually hyperactive
What are UMN signs?
- Weakness
- Hyperreflexia
- Pathologic reflexes
- Inc tone
What are the Frontal Release Signs?
- Inc jaw jerk
- Snout reflex
- Palmo-mental reflex
What is the Snout reflex?
Pouting or pursing of lips that is elicited by light tapping of closed lips near midline
What is the Palmomental reflex?
Primitive reflex consisting of a twitch of the chin muscle elicited by stroking the palm
