Ataxic Dysarthria
Without order
What is ataxia
Excessive excitation that yields hypotonus and hyperreflexia
Spasticity
Site of lesion for flaccid dysarthrias
Most common cause of hyperkinetic dysarthria
unknown
impairment of basal ganglia control circuits
Ataxic dysarthria arises from damage to this structure
What is the cerebellum?
Spastic dysarthria arises from damage to this structure
bilateral direct and indirect pathways for volitional movement in the CNS (upper motor neurons)
Underlying neuromotor impairment associated with flaccid dysarthria
Weakness and reduced muscle tone (hypotonus) in voluntary muscles and flaccid paralysis
Common syndromes associated with hyperkinetic dysarthria
Tourette's syndrome, Athetoid cerebral palsy, dyskinesia, chorea, spasmodic dysphonia
Common causes of hypo kinetic dysarthria
Parkinson's disease and degenerative diseases
Main characteristics of ataxic dysarthria and features that distinguish it from other dysarthria
Main: Incoordination and control
Irregular articulatory breakdowns, telescoping (deletion of syllables from words and/or the collapsing of syllables into each other during speech), irregular speech AMRs, excess and equal stress, excess loudness variation, and distorted vowels.
Symptoms usually affect multiple subsystems of speech and muscle weakness and spasticity with the result of slow the movements for speech and reducing their range and force.
Large, visible, arrhythmic, isolated, twitches of resting muscle that spontaneously occur in muscles that have been denervated
What is fasciculations?
Main characteristics of hyperkinetic dysarthria
Excessive movements
Effects on rate and prosody
Most prominent feature of hypo kinetic dysarthria that may also appear as the first symptom
Other common characteristics
Dysphonia - inadequate loudness, breathiness reducing to a whisper, and vocal flutter
Difficulty initiating movement and little range of motion, rapid speech AMRs, excessive muscle tone (hypertonus)
phonation, articulation, and prosody
Causes of ataxic dysarthria
Most common = degenerative
Vascular, demyelinating, tumor, traumatic, toxic, and some unknown
Causes of Spastic dysarthria
Degenerative disease and stroke make up approx. 3/4 of cases
Invisible, spontaneous, independent contractions of individual muscle fivers that spontaneously arise due to slow, repetitive action potentials in muscle that have been denervated
What is fibrillations?
Features of hyperkinetic dysarthria of chorea
transient and unpredictable nature of the deviant speech characteristics.
Strained-harshness, transient breathiness, hypernasality, artic distortions and irregular artic breakdowns, loudness variations, and sudden forced inspiration or expiration which lead to prolonged intervals and phonemes, variable rate, inappropriate silences, voice stoppages, and excessive or insufficient stress patterns
characteristics of Parkinsonism
Collection of symptoms associated with basal ganglia damage that are associated with a variety of etiologies, including Parkinson’s disease
Common nonspeech characteristics = resting tremor, rigidity, bradykinesia or hypkinesia, akinesia, and postural abnormalities
Treatment goals for ataxic dysarthria
Improve muscle tone and speech movement coordination
Exercises to compensate for or to strengthen weak muscles
Treatment for spastic dysarthria
Medicine, surgery (pharyngeal flap), prosthetic, and behavioral interventions that facilitate muscle relaxation for easier movement
Focus of treatment for flaccid dysarthria
counteracting the effects of muscular weakness in affected speech muscles with strengthening exercises, prosthetic supports, and behavioral speech training exercises
Why is treatment of hyperkinetic dysarthria difficulty?
Since movements characterized by the disorder or dysarthria are not under volitional control, medical/surgical and pharmacological treatment methods are most effective
Focus of treatment for hypo kinetic dysarthria
controlling rate and increasing loudness