Mixed Dysarthrias Flashcards
Why are mixed dysarthrias common?
THe damage that causes dysarthrias often affects more than one area or system.
What is the most common dysarthria according to one of the figures in the book?
mixed dysarthria
You can have a combination of ___ or more of these pure dysarthrias?
2
Which component dominates in mixed dysarthrias?
The first name given
Why is it important to determine the types of mixed dysarthrias and the components?
It may help rule our or confirm neurological diagnoses.
What are the etiologies of mixed dysarthria?
commonly caused by more than one event. multiple strokes, combination of neurological or degenerative diseases such as PD and stroke, chorea and stroke
-often seen in degenerative diseases
Mixed dysarthria is often seen in ______ diseases.
degenerative
What are the types of mixed dysarthrias and precentages in Duffy’s practice?
- Ataxic-flaccid-spastic: 6%
- Hypokinetic-spastic 7%
- Other mixes: 19%
- Ataxic-spastic: 23%
- Hyperkinetic-hypokinetic: 35%
- Flaccid-spastic: 42%
What is the most common etiology of mixed dysarthrias?
degenerative diseases
Name the different degenerative diseases that can cause mixed dysarthria?
1-motor neuron disease 2- multiple sclerosis 3-Frederich's Ataxia 4- Progressive Supranuclear Palsy 5- Multiple Systems Atrophy 6- Corticobasal degeneration
what are the different motor neuron diseases that can cause mixed dysarthria?
-ALS: bulbar or spinal
-Primary lateral sclerosis
-
What is the most common motor neuron disease that causes mixed dysarthria?
ALS: amyotrophic lateral sclerosis
What is amyotrophic lateral sclerosis (ALS)
Has both UMN and LMN involvement. Commonly has mixed spastic-flaccid or flaccid-spastic components. It can be hard to diagnose. Nearly always fatal. Most die between 2 to 5 years after diagnosis. Some few live more than 12 years. Death usually due to respiratory failure - but person can be put on ventilator.
ALS occurs in ___ to ___ per 100,000.
1-5
Who is affected more by ALS?
men
_____ of ALS is familial.
5%
What is the onset for people with ALS?
Between 40- 70 years
When do most people with ALS die?
between 2 to 5 years after diagnosis. SOme few live more than 12 years.
What do people with ALS usually die from?
respiratory failure
ALS can be _____ or ______.
bulbar
spinal
Patients with ______ ALS onset have ______ and _____ problems very early on.
bulbar
speech
swallowing
Patients with spinal onset have problems with _____ first.
limbs
Patiens with bulbar ALS onset have what king of problems very early on?
speech and swallowing
How is a diagnosis of ALS confirmed?
EMG findings of weakness
What is primary lateral sclerosis (PLS)?
Affects UMN only. It may be hard to distinguish from ALS. It typically produces spastic dysarthria but is hard to differentiate from ALS.
________ is hard to differentiate from ALS.
Primary lateral sclerosis (PLS)
Primary lateral sclerosis typically produces what type of dysarthria?
spastic
What is spinal muscle atrophies?
Affects LMN only - progressive limb wasting and weakness - may have some cranial nerve weakness as well. It is a motor neuron disease but typically produced only flaccid dysrthria. not mixed.
What does primary lateral sclerosis affect?
UMN only
What does spinal muscle atrophies affect?
LMN only
What is progressive bulbar palsy?
Primarily has LMN weakness of cranial nerve muscles. Dysarthria and dysphagia predominate. Similar to ALS without limb involvement. It is usually associated with flaccid dysarthria, not mixed.
Bulbar palsy has primarily _____ weakness of cranial nerve muscles.
LLMN
______ and ______ predominate with bulbar palsy.
Dysarthria and dysphagia
Bulbar palsy is usually associated with ______ dysarthria.
flaccid
What is multiple sclerosis?
It is a demyelination disease - the myelination is attacked but the axon itself is not. It is the most common CNS disease affecting young and middle age adults between 20 to 40 years of age. It affects more women than men. Cause is unknown - may be related to autoimmune cause triggered by environmental and genetic interactions. Diagnosis is difficult- MRI often used for diagnosis.
What is the most common CNS disease affecting young and middle age adults between the ages of 20-40.
Multiple sclerosis