Dysarthria/Dysphagia Flashcards

1
Q

What are Dysarthria/Dysphagia sx caused by?

A

Weakness of oropharyngeal muscles

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2
Q

Where do CN controlling speech & swallowing originate?

A

Medulla

(except CN VII)

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3
Q

What are the sx of myopathy?

A
  • Difficulty articulating speech or swallowing or both
  • Onset gradual
  • No sensory complaint
  • Symmetrical
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4
Q

What are the PE findings of myopathy?

A
  • Gag reflex intact
  • Symmetrical & proximal weakness
  • Sx do not wax/wane
  • Normal DTRS
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5
Q

What are the tech features of myopathy?

A
  • +/- inc CPK
  • +/- genetic testing
  • +/- thyroid function ABN
  • Ach receptor Ab negative
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6
Q

What is the hx of Progressive Bulbar Palsy?

A

Older age group

Gradual onset

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7
Q

What are the PE findings of Progressive Bulbar Palsy?

A
  • Dysarthria/dysphagia
  • Dec gag reflex
  • Atrophy & fasiculations of tongue
  • Late course may turn into typical ALS
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8
Q

What is the cause of Progressive Bulbar Palsy?

A

Variant of Motor Neuron dz or ALS

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9
Q

What is the tx for Progressive Bulbar Palsy?

A
  • Dietary modification
  • Speach & swallow therapy
  • Eventually feeding tube required
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10
Q

What is the hx of Pseudobulbar Palsy?

A
  • Dysarthria/dysphagia
  • Emotionaly labile w/ spon bursts of laughter or crying
  • Hx of multiple small strokes
  • Hx of falls
  • Vascular RF
  • Younger adults–MS
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11
Q

What are the PE findings of Pseudobulbar palsy?

A
  • MC bilateral UMN signs (freq unilateral)
  • Frontal release signs
  • No atrophy of tongue
  • Gag reflex usually hyperactive
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12
Q

What are UMN signs?

A
  • Weakness
  • Hyperreflexia
  • Pathologic reflexes
  • Inc tone
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13
Q

What are the Frontal Release Signs?

A
  • Inc jaw jerk
    • Snout reflex
    • Palmo-mental reflex
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14
Q

What is the Snout reflex?

A

Pouting or pursing of lips that is elicited by light tapping of closed lips near midline

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15
Q

What is the Palmomental reflex?

A

Primitive reflex consisting of a twitch of the chin muscle elicited by stroking the palm

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16
Q

What are the tech features of Pseudobulbar Palsy?

A

ABN brain imaging showing bilateral deep white matter lesion in the upper brainstem, diencephalon &/or bilateral deep cerebral hemispheres

17
Q

What is Pseudobulbar palsy?

A

UMN dz wherein bilateral supranuclear lesions cause UMN weakness of the muscles of speaking & swallowing