Hyperkinetic Dysarthria Flashcards
Hyperkinetic Dysarthria: Overview
Associated with BG control circuit abnormalities
Can manifest in any/all levels of speech production; prominent in prosody and rate.
Impression that speech is being interfered with by involuntary movements that distort, slow, or interrupt its movement
Observing abnormal head, orofacial, and resp. movements facilitates diagnosis
Hyperkinetic Dysarthria: Characteristics
Deviant speech characteristics are result of abnormal, rhythmic, or irregular rapid or slow involuntary movements.
Perceptually distinguishable from other dysarthrias
Clinical Characteristics of BG Control Circuit Disorders Associated with Hyperkinetic Dysarthrias
Abnormal, involuntary movements can occur at rest, during static postures, or during voluntary movement.
Some hyperkinesias are rapid, unsustained, or unpatterned; others are slower, may be prolonged.
Dyskinesia
Term that refers to abnormal, involuntary movements regardless of etiology.
Most hereditary or acquired conditions that cause orofacial dyskinesias are associated with BG abnormalities.
Orofacial dyskinesias are a common side effect of antipsychotics.
Myoclonus
Characterized by involuntary single or repetitive brief, lightening-like jerks of a body part; jerks can be rhythmic or not.
Can be confined to a single muscle or be multifocal.
Can occur spontaneously or triggered by visual, tactile, or auditory stimuli.
Can result from TBI, encephalopathies, toxic conditions, infectious diseases.
Tics
Rapid, stereotyped, coordinated or patterned movements that are under partial voluntary control.
Complex tics are coordinated and sometimes including:
- Jumping
- Noises
- Coprolalia
- Lip smacking
- Touching
Chorea
Characterized by involuntary, rapid, non-stereotypic, random, purposeless movements of body structures.
Present at rest, during sustained postures, and voluntary movement.
Causes can be:
- Degenerative
- Inflammatory
- Infectious
- In response to drugs
- During pregnancy
Ballismus
Involves gross, abrupt contractions of axial and proximal muscles of extremities that produce wild, flailing movements.
When unilateral, the condition is called hemiballismus.
Athetosis
Characterized by slow, writhing, purposeless movements that tend to flow into one another.
Often considered a major category of cerebral palsy.
Dystonias
A collection of syndromes and physical signs characterized by involuntary abnormal postures resulting from excessive co-contraction of agonist and antagonist muscles.
Can be primary or secondary to other neurologic conditions.
Movements can be slow and sustained with quick movements superimposed occasionally.
Specific Dystonias
When only orofacial muscles are involved, it’s called Orofacial Dystonia, and can be focal or confined to a single structure.
Cervical dystonia is characterized by tonic or clonic spasms of the neck muscles, which causes deviation of the head to the left or right, or sometimes back or forward.
Spasm
Term that designates various abnormal muscular contractions.
Spasms are usually involuntary
- Tonic Spasms are prolonged or continuous.
- Clonic spasms are repetitive, rapid in onset, and brief.
Tremor
Most common involuntary movement.
Involves rhythmic, periodic movements of a body part.
- Resting Tremor occurs when the body part is in repose
- Postural Tremor occurs when the body part is maintained against gravity
- Action Tremor occurs during movement
- Terminal Tremor occurs as the body part nears a target.
Etiologies
Caused by any process that damages the circuitry associated with hyperkinesias.
Cause is frequently unknown but can include:
- Degenerative
- Toxic/Metabolic
- Infectious
- Vascular
- Trauma
- Neoplastic
- Inflammatory
Degenerative Diseases
Chorea is the most common characteristic, along with dementia, depression, personality changes, attention deficits, dysarthria, and dysphagia.
