Dysarthria
Background
- Motor speech disorder characterized by poor articulation of language sounds or pronounciation[1]
- Cranial nerves involved include trigeminal nerve's motor branch (V), facial nerve (VII), glossopharyngeal nerve (IX), vagus nerve (X), and hypoglossal nerve (XII).
Clinical Features
- Includes abnormality to any of the following: breath control, duration of syllables, pitch, range, speed, steadiness, timing, tone, vocal quality, pitch, volume[2]
Differential Diagnosis
Stroke Types
Weakness
Neuromuscular weakness
- UMN:
- Spinal cord disease:
- Infection (Epidural Abscess (Spinal))
- Infarction/ischemia
- Trauma (Spinal Cord Syndromes)
- Inflammation (Transverse Myelitis)
- Tumor
- Peripheral nerve disease:
- Lyme disease
- Guillain-Barre syndrome
- Toxins (Ciguatera)
- Tick paralysis
- Diabetes mellitus neuropathy (non-emergent)
- NMJ disease:
- Muscle disease:
- Rhabdomyolysis
- Dermatomyositis
- Polymyositis
- Alcoholic myopathy
- Non-neuromuscular weakness
- Can't miss diagnoses:
- Sepsis (Main)
- Hypoglycemia
- Periodic paralysis (electrolyte disturbance, K, Mg, Ca)
- Respiratory failure
- Other
- Can't miss diagnoses:
Evaluation
- Clinical diagnosis
- Consider CVA or other neurologic workup
Management
- Treat underlying cause
- Speech pathology
Disposition
- Depends on underlying cause
See Also
References
- ↑ Duffy, J. Defining, Understanding, and Categorizing Motor Speech Disorders. In: Duffy, J. Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. 3rd ed. . St. Louis, Mo: Elsevier Mosby; 2012 ISBN 0323024521.
- ↑ MacKenzie, C (2011). "Dysarthria in stroke: A narrative review of its description and the outcome of intervention". International Journal of Speech-Language Pathology 13 (2): 125–36. doi:10.3109/17549507.2011.524940. PMID 21480809