Dysarthria

WikiDoc Resources for Dysarthria
Articles
Most recent articles on Dysarthria Most cited articles on Dysarthria Review articles on Dysarthria Articles on Dysarthria in N Eng J Med, Lancet, BMJ
Media
Powerpoint slides on Dysarthria Images of Dysarthria Photos of Dysarthria Podcasts & MP3s on Dysarthria Videos on Dysarthria
Evidence Based Medicine
Cochrane Collaboration on Dysarthria Bandolier on Dysarthria TRIP on Dysarthria
Clinical Trials
Ongoing Trials on Dysarthria at Clinical Trials.gov Trial results on Dysarthria Clinical Trials on Dysarthria at Google
Guidelines / Policies / Govt
US National Guidelines Clearinghouse on Dysarthria NICE Guidance on Dysarthria NHS PRODIGY Guidance FDA on Dysarthria CDC on Dysarthria
Books
Books on Dysarthria
News
Dysarthria in the news Be alerted to news on Dysarthria News trends on Dysarthria
Commentary
Blogs on Dysarthria
Definitions
Definitions of Dysarthria
Patient Resources / Community
Patient resources on Dysarthria Discussion groups on Dysarthria Patient Handouts on Dysarthria Directions to Hospitals Treating Dysarthria Risk calculators and risk factors for Dysarthria
Healthcare Provider Resources
Symptoms of Dysarthria Causes & Risk Factors for Dysarthria Diagnostic studies for Dysarthria Treatment of Dysarthria
Continuing Medical Education (CME)
CME Programs on Dysarthria
International
Dysarthria en Espanol Dysarthria en Francais
Business
Dysarthria in the Marketplace Patents on Dysarthria
Experimental / Informatics
List of terms related to Dysarthria

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Dysarthria is a speech disorder resulting from neurological injury, characterised by poor articulation (cf aphasia: disorder of the content of speech). Any of the speech subsystems (respiration, phonation, resonance, prosody, articulation and movements of jaw and tongue) can be affected.

Disarthic speech is due to some disorder in the nervous system, which in turn hinders control over for example tongue, throat, lips or lungs. Swallowing problems, dysphagia, are often present.

Cranial nerves that control these muscles include the facial nerve (VII), the glossopharyngeal nerve (IX), the vagus nerve (X), and the hypoglossal nerve (XII).

Classification

Dysarthrias are classified in multiple ways based on the presentation of symptoms. Specific dysarthrias include Spastic, Flaccid, Hyperkinetic, Hypokinetic, Ataxic, Unilateral upper motor neuron, and Mixed dysarthria.

Pathophysiology

The reasons behind dysarthria can be many; among the diseases are ALS, Parkinson's disease, botulism, cranial nerve lesions, chorea, prion protein related diseases, and cerebral palsy. Dysarthria can also be an early symptom of stroke, and of other forms of traumatic brain injury. More common causes are intoxication and anesthesia, although these are transient. Another possibility is myasthenia gravis.

Causes

In alphabetical order.

Causes by Organ System

Cardiovascular	Amyloidosis, Basilar artery insufficiency, Brainstem infarction , Brainstem stroke, Cardiofaciocutaneous syndrome, Cerebellar infarction , Cerebral stroke , Cerebrovascular accident, Noonan syndrome, Stroke
Chemical/Poisoning	Anesthesia, Botulinum toxin, Manganese poisoning, Organophosphate poisoning
Dental	No underlying causes
Dermatologic	Dermatomyositis
Drug Side Effect	Asenapine maleate, Carbamazepine, Cytarabine, Lacosamide, Lomustine, Loxapine, Olanzapine, Oprelvekin, Perphenazine, Pramipexole
Ear Nose Throat	Enlarged tongue, Hearing loss, Macroglossia
Endocrine	Amyloidosis, Hypothyroidism, Maturational delay, Woodhouse-sakati syndrome
Environmental	No underlying causes
Gastroenterologic	No underlying causes
Genetic	Charlevoix-saguenay spastic ataxia, Mitochondrial disease, Noonan syndrome, Progressive external ophthalmoplegia, autosomal recessive, Turner syndrome, Wilson's disease, Wolfram's disease, Woodhouse-sakati syndrome
Hematologic	No underlying causes
Iatrogenic	Anesthesia
Infectious Disease	Abscess, Anaerobic infection, Botulism, Diptheria, Guillain-barre syndrome, Lyme disease, Poliomyelitis
Musculoskeletal/Orthopedic	Muscular dystrophy, Myasthenia gravis, Myotonic muscular dystrophy, Polymyositis, Progressive external ophthalmoplegia, autosomal recessive
Neurologic	Acquired brain injury, Acute dystonic reaction, Alcoholic cerebellar degeneration, Amyotrophic lateral sclerosis, Anticonvulsant intoxication, Articulation disorders, Basal ganglia disorders, Basilar artery insufficiency, Botulism, Brain injury, Brain tumor, Brainstem infarction , Brainstem tumor, Brainstem stroke, Central pontine myelinosis, Cerebellar disorders, Cerebellar infarction , Cerebellar syndrome, Cerebral palsy, Cerebral stroke , Cerebrovascular accident, Charlevoix-saguenay spastic ataxia, Degenerative brain disease, Dementia, Dermatomyositis, Diabetic nerve infarction, Friedreich's ataxia, Guillain-barre syndrome, Hearing loss, Huntington's disease, Motor neurone disease, Multiple sclerosis, Muscular dystrophy, Myasthenia gravis, Myotonic muscular dystrophy, Neuroferritinopathy, Neuron lesions of cranial nerve ix, Neuron lesions of cranial nerve x, Olivopontocerebellar degeneration, Parkinson disease, Parkinsonism, Parkinson's disease, Partington x-linked mental retardation syndrome, Phonology disorders, Progressive supranuclear palsy, Resonance disorders, Spinocerebellar ataxias, Wilson's disease, Worster-drought syndrome
Nutritional/Metabolic	Diabetic nerve infarction, Neuroferritinopathy
Obstetric/Gynecologic	No underlying causes
Oncologic	Brain tumor, Brainstem tumor
Ophthalmologic	No underlying causes
Overdose/Toxicity	Alcoholic cerebellar degeneration, Anticonvulsant intoxication
Psychiatric	Psychologic disorders
Pulmonary	No underlying causes
Renal/Electrolyte	Central pontine myelinosis
Rheumatology/Immunology/Allergy	Amyloidosis, Polymyositis
Sexual	No underlying causes
Trauma	Abscess, Head injury, Head trauma, Hearing loss, Poorly fitting mouth appliances
Urologic	No underlying causes
Miscellaneous	No underlying causes

Neurological

• Abscess
• Amyotrophic Lateral Sclerosis (ALS)
• Botulism
• Brainstem stroke
• Dermatomyositis
• Diabetic nerve infarction
• Hypothyroidism
• Mitochondrial disease
• Myasthenia gravis
• Myotonic muscular dystrophy
• Nerve gas/ organophosphate poisoning
• Parkinson's Disease
• Polymyositis
• Prolonged effects of anesthesia
• Stroke
• Tumor

Structural

• Tumors:

  • Lips
  • Squamous cell epithelium of the oropharynx and vocal cords
  • Tongue

Less Common Etiologies

• Acute dystonic reaction
• Amyloidosis
• Anaerobic infection
• Cleft palate
• Mild cerebral palsy
• Poor dentition or ill-fitting dentures
• Sedative/anticonvulsant intoxication
• Unrecognized foreign accent

Drug Side Effect

• Asenapine maleate
• Cytarabine
• Botulinum toxin
• Eslicarbazepine acetate
• Flurazepam
• Lacosamide
• lomustine
• Loxapine
• Olanzapine
• Oprelvekin
• Pramipexole
• Perphenazine
• Triazolam

Treatment

The articulation problems that dysarthria causes can be treated together with a speech language pathologist using a range of techniques which sometimes includes strengthening the speech musculature. Devices that make coping with dysarthria easier include speech synthesis software and text-based telephones.