Week Three Flashcards
How are the cerebellum and basal ganglia involved in speech movements?
- They both have bidirectional communication with the cerebral cortex
- Help with motor control
- Damage = errors in movement execution
Where does a lesion have to occur for ataxic dysarthria to occur?
In the cerebellum
What purpose does the cerebellum have in speech?
- refinement
- tempo/ rate
- timing
- steadiness
- combining
- sequencing movements
- ensures smooth, well-timed, durationally and prosodically appropriate speech utterances
What are some causes of ataxic dysarthria
- Degenerative disease (e.g., cerebellar degeneration)
- Friedreich’s ataxia - Demyelinating (MS)
- Stroke
- Trauma
- Tumour
What are some non-speech signs of ataxic dysarthria?
Ataxia
- can’t create smooth, fluid motions
Distrubed posture and gait
- wide stance when walking
Tremor
- Intention tremor
Dysdiadochokinesia
- Difficulty preforming rapidly alternating movements
What are the speech signs of ataxia dysarthria?
- Most difficulty with articulation and prosody
Articulation
- imprecise consonants
- slurred
- Slow AMR’s with distortion (incorrect articulation /pa/ - /fa/) and irregular
Prosody
- Excess and equal stress (a little robotic
- Slow
What purpose does the basal ganglia have in speech?
Important in inhibition and excitation
Dopamine plays an important role in activating movements
Any imbalance in dopamine = degraded motor control performance
Where does a lesion occur to result in hypokinetic dysarthria?
Lesion occurs in the basal ganglia
Results in too much inhibition and too little excitation
= reduced mobility (hpokinesia) / too little movement
What are some causes of hypokinetic dysarthria?
- Main cause is Parkinson’s Disease (occurs in 70-90% of PD cases)
- Other causes include:
- other degenerative diseases
- Vascular
- Traumatic
What are some non-speech signs of Parkinson’s disease?
Akinesia/hypokinesia (absence of/reduced movement)
- smaller movements
- Less spontaneous movements (bracing when fall)
- Reduction of automatic movements (arm swinging)
- mask-like facial expression
Tremor at rest
Slow to initiate and execute movement (bradykinesia)
Movement may to hard to stop (speedtrap)
Cognitive decline
Dementia
Depression
What are some speech characteristics of hypokinetic dysarthria?
Phonation/respiration
- reduced loudness
- breathy
- monopitch
- lack of stress
Articulation
- imprecise
- ARM’s very rapid and repeated syllables
fast
presenting complaints
- rapid
-mumbling
- difficulty initiating
- reduced loudness
- May very sensory deficits (lack of awareness)
Where does a lesion occur to result in hyperkinetic dysarthria?
Occurs in the basal ganglia
Increase of dopamine release
Too little inhibition and too much excitation
= excessive/involuntary/unwanted movements = hyperkinesia
What are some causes of hyperkinetic dysarthria?
- Huntington’s disease
- infectious
- vascular
- Trauma
What are some non-speech signs of hyperkinetic dysarthria?
- Myoclonic jerks (sudden jerking of muscles)
- Chorea (=dance)
- Tremor (during action)
- Dystonia (sudden and increased muscle contractions)
What are some speech characteristics of hyperkinetic dysarthria?
Phonation
Strained/breathy irregular
variation in loudness
voice stoppages
Resonance
nasal
Articulation
difficulty starting
Movements/muscle contraction
-Abnormal, irregular, unpredictable
Presenting complaints
- Inability to control or inhibit movements
- Shaky and tight voice
- Slurred and slow speech
