Motor Speech Disorders

Question 1

Flaccid Dysarthria

Answer 1

LMN
Weakness, hypotonia, hypernasality, breathiness, nasal emissions, audible inspiration, short phrases

Question 2

Spastic Dysarthria

Answer 2

LMN
Spasticity, increased muscle tone, hyperexcitable reflexes, pathologic oral reflexes, pesudobulbar affect, slow speaking rate, low pitch, strained-strangled voice, dysphagia, drooling

Question 3

Ataxic dysarthria

Answer 3

Cerebellum
Incoordination (overshoot, undershoot, errors in sequencing movements) motor symptoms (stance, gait, titubation, nystagmus, intentional tremor), irreguar AMRs, distorted vowels, irregular articulation breakdowns, excess and equal stress, prolonged phonemes, explosive (loud) speech

Question 4

Hypokinetic Dysarthria

Answer 4

Basal ganglia (too much inhibition)
Rigidity, reduced range of motion and force, variable rate, short rushes of speech, syllable repetitions (sounds disfluent), reduced loudness, innapropriate silences

Question 5

Hyperkinetic Dysarthria

Answer 5

Basal ganglia (too little inhibition)
Involuntary movements, slow and irregular AMRs, distorted vowels, irregular breakdowns, variable rate, prolonged phonemes and intervals, harshness, strained-strangled quality, transient breathiness, sudden forced inspiration

Question 6

Unilateral UMN

Answer 6

Unilateral UMN
One sided weakness, incoordination, spasticity, imprecise speech sounds, slow speaking rate, mild/temporary drooling/dysphagia
- Unilateral stoke (92%), tumor, trauma

Question 7

Locked- In Syndrome

Answer 7

Patient is completely immobile and cannot communicate, lang and comprehension intact
Flaccid dysarthria

Question 8

Guillain-Barre Syndrome

Answer 8

Demyelination, progressive, caused by an immune response
Flaccid dysarthria

Question 9

Myasthenia Gravis

Answer 9

Muscle fatigue with activity (loss of AChRs); requires rest
Flaccid Dysarthria

Question 10

Muscular Dystrophy

Answer 10

Progressive weakness and loss of muscle mass
Flaccid Dysarthria

Question 11

ALS

Answer 11

Progressive neurodegenerative disease affecting muscles (causing weakness)
Spastic dysarthria

Question 12

Progressive Supranuclear palsy

Answer 12

Deterioration of cells in areas of your brain that control body movement, coordination, thinking, and other important functions
Spastic Dysarthria

Question 13

Parkinson’s

Answer 13

Decreased dopamine causing resting tremor, rigidity, akinesia/bradykinesia, loss of postural reflexes
Hypokinetic dysarthria

Question 14

Parkinson’s Plus syndromes

Answer 14

Progressive supranuclear palsy, multiple systems atrophy, transition from PD hypokinetic to mixed
Hypokinetic dysarthria

Question 15

Dystonia

Answer 15

Slow hyperkinesia in which muscles have involuntary tonic contractions causing abnormal postures and no weakness. More likely to occur with movements.
Hyperkinetic dysarthria

Question 16

Huntington’s Chorea

Answer 16

Deficiency in GABA > reduced inhibition > increased activation of dopa neurons in basal ganglia > quick and unpredicatble movements at rest and during movement.

Question 17

Friedrich’s Ataxia

Answer 17

Damage to parts of your brain and spinal cord and can also affect your heart.