Neurogenic Speech Disorders

Question 1

Neurogenic Speech Disorders

Answer 1

Muscles of speech production which includes the face, lips, jaw, tongue, soft palate, vocal cords, respiratory system, are innervated (moved) by nerves arising from the base of the brain (cranial nerves).

Question 2

Etiology

Answer 2

damage to the central nervous system can cause disruption of the motor systems involved in speech production

Question 3

Apraxia of Speech

Dysarthrias

Answer 3

In adults these are acquired disorders, meaning they result from some sort of damage or trauma to the neuromuscular system
In children both acquired and developmental forms of apraxia and dysarthria occur

Question 4

Apraxia

Answer 4

Also called verbal apraxia
A disorder in which the patient has trouble speaking because of a cerebral lesion that prevents the execution of voluntary and on command movements of the complex motor movements involved in speaking
Movements affected despite the fact that muscle strength is not affected
May be able to execute a movement on an involuntary basis, but unable to perform on a voluntary basis

Question 5

Oral Apraxia

Answer 5

Difficulty in the voluntary execution of the orofacial muscles in the presence of preserved ability to perform automatic movements with the same muscles
e.g. patient may not be able to stick out their tongue on command, but you may see them lick their lips

Question 6

Verbal Apraxia or Apraxia of speech

Answer 6

Impairment in the ability to position the musculature and to sequence the muscle movements for volitional production of phonemes and sequences of phonemes, not accompanied by significant weakness slowness or incoordination.
Impairment in the ability to position the articulators for the production of speech sounds.

Question 7

Testing for Oral and Verbal Apraxia

Answer 7

Oral Apraxia
Stick out your tongue
Blow
Show me your teeth
Bite your lip
Clear your throat
Smile
Puff up your cheeks

Verbal Apraxia (have patient say)
Snowman
Several
Gingerbread
Impossible
Statistical Analysis
Methodist Episcopal
Zip-Zipper-Zippering

Question 8

Dysarthria

Answer 8

A group of related motor speech disorders resulting from disturbed muscular control of the speech mechanisms.
Can have devastating effects on intelligibility
Manifested by:
Paralysis
Weakness
Abnormal timing of the speech mechanisms
Incoordination of the speech muscles

Question 9

Flaccid Dysarthria

Answer 9

Muscles are weak 
Affected side of the mouth will sag
Drooling may be present
Tongue may show tremors
Tongue may atrophy over time – shrink and become flabby
Speech Characteristics
Imprecise consonants
Voice may be breathy
No variation of pitch or loudness

Question 10

Spastic Dysarthria

Answer 10

Increased tone of muscles, although muscles are weak
Range of movement is limited
Rate of movement is slow
Tongue will deviate to the weak side
Face may droop on the affected side
Speech Characteristics
May be described as harsh
Strained, strangled quality
Pitch may be low

Question 11

Other Types of Dysarthria

Answer 11

Hypokinetic Dysarthria
Typical of Parkinson’s Disease
Hyperkinetic Dysarthris
Involuntary movement disorders – Huntingtons chorea
Ataxic Dysarthria
Disruption in the smooth coordination of movements
Patient may overshoot their target
Mixed Dysarthria
Mixed spastic and ataxic – Multiple Sclerosis patients