Spastic Dysarthria

Question 1

Hallmarks of spastic dysarthria

Answer 1

Reduced range; reduced spee

Question 2

Overarching cause of spastic dysarthria

Answer 2

Bilateral UMN damage

Question 3

Direct and indirect activation pathways

Answer 3

Direct (corticobulbar): facilitate discrete voluntary movements
Indirect (basal ganglia): Regulate reflexes, posture, and tone

Question 4

UMN damage to direct activation pathway

Answer 4

Loss of skilled movement; hypotonia

Question 5

UMN damage to indirect activation pathway

Answer 5

Increased muscle tone (hypertonia); spasticity; hyperactive reflexes

Question 6

Distinguishing signs of UMN damage

Answer 6

Spasticity (spastic weakness)
Normal or increased reflexes
Involves many muscle groups

Question 7

Lability

Answer 7

Also known as pseudobulbar effect; pt. has random outbursts of crying or laughing

Question 8

Neuromuscular deficits (direction, range, rhythm, rate, force, tone)

Answer 8

Direction: Normal
Range: Reduced
Rhythm: Regular for repetitive movements
Rate: Reduced
Force: Reduced
Tone: Excessive

Question 9

Speech characteristics in spastic dysarthria

Answer 9

Voice: often harsh
Prosody: slow, excess and equal stress

Question 10

Pt. complaints

Answer 10

Slow speech
Increased effort
Chewing and swallowing problems
Lability

Question 11

CVA and spastic dysarthria

Answer 11

Bilateral cortical, lacunar infarcts, or single brainstem

Question 12

Binswanger’s subcortical encephalopathy

Answer 12

UMN disorder caused by hypertensive lacunar strokes

Question 13

Primary lateral sclerosis

Answer 13

Degenerative corticobulbar and corticospinal disease largely affecting the limbs

Question 14

Unilateral UNM Dysarthria

Answer 14

Uncommon and rarely worse than moderate; usually resolves. pt’s complain of slurred speech, chewing difficulties, or drooling on the affected side.