Unilateral Upper Motor Neuron Dysarthria

Question 1

Unilateral Upper Motor Neuron Dysarthria: Overview

Answer 1

Associated with damage to the UMN pathways that carry impulses to the cranial and spinal nerves that supply the speech muscles.

Can manifest in any level of speech production but most apparent in articulation, prosody, phonation.

Clinical features reflect effects of unilateral UMN weakness in face and tongue and sometimes other levels of the speech system.

Usually mild to moderate in severity with good prognostics.

Question 2

UUMN Dysarthria: Characteristics

Answer 2

• Weakness and spasticity, hypotonia in affected limbs.

- Spasticity, hyperactive stretch reflex, increased muscle tone emerge over time

Question 3

Etiologies

Answer 3

Any process that can damage UMNs unilaterally can cause UUMN dysarthria.

Tumors
Trauma
Stroke

Question 4

Stroke

Answer 4

Unilateral stroke is the most common cause of UUMN damage.

Left carotid or MCA occlusions are most common cause of deficits accompanied by aphasia or apraxia of speech.

Right carotid or MCA occlusions are most common cause of deficits accompanied by neglect and RH cognitive disturbances

Question 5

Patient Perceptions and Concerns

Answer 5

• Distress over severe dysarthria impact on intelligibility
• Speech is “slurred” or “thick”
• Speech deteriorates under fatigue or stress
• Drooling
• Heavy feeling on affected side of face

Question 6

Non-Speech Oral Mech

Answer 6

Weakness at rest and during movement

Question 7

Speech

Answer 7

Imprecise consonants are most pervasive deficit.

Imprecise, slow AMRs

Imprecise articulation due to unilateral lower face and tongue weakness

Harsh vocal quality

Reduced loudness

Mild hypernasality