DIfferential Dx

Question 1

OME findings: Flaccid (6)

Answer 1

Atrophy, fasciculations, hypotonia, hypoactive gag, rapid deterioration, nasal regurgitation

Question 2

OME findings: Spastic (5)

Answer 2

Pathologic oral reflexes, PBA, hyperactive gag, dysphagia, drooling

Question 3

OME findings: Hypokinetic (3)

Answer 3

Facial masking, orofacial tremulousness, reduced ROM for AMR

Question 4

OME findings: Hyperkinetic (1)

Answer 4

Adventitious movements (abnormal involuntary movements of orofacial muscles) may be present

Question 5

OME findings: UUMN (1)

Answer 5

Unilateral facial or lingual weakness without atrophy or fasciculations

Question 6

Distinguishing speech findings: Flaccid (8)

Answer 6

Breathiness, diplophonia, hypernasality, audible nasal emission, audible inspiration, short phrases, rapid deterioration and recovery with rest, speaking on inhalation

Question 7

Distinguishing speech findings: Spastic (6)

Answer 7

Harshness*, low pitch, slow rate, strained-strangled, pitch breaks, slow/regular AMRs

Question 8

Speech findings: Ataxic (6)

Answer 8

Irregular articulatory breakdowns, irregular AMRs, distorted vowels, excess loudness variation, telescoping syllables,

Question 9

OME findings: Ataxic (2)

Answer 9

Can be normal. May have dysmetric nonspeech movements

Question 10

Speech findings: Hypokinetic (12)

Answer 10

Monopitch, monoloud, reduced loudness
reduced stress, inappropriate silences, short rushes of speech,
variable rate, increased rate in segments, increased overall rate
rapid and blurred AMRs
repeated phonemes, palilalia

Question 11

Speech findings: Hyperkinetic (13)

Answer 11

Slow and irregular AMRs, distorted vowels, excess loudness variation, sudden forced inspiration/expiration, prolonged intervals, voice stoppages, transient breathiness, voice tremor, myoclonus, intermittent hypernasality, deterioration with increased rate, inappropriate vocal noises, coprolalia

Question 12

Common speech findings: UUMN (4)

Answer 12

Slow rate, irregular artic breakdowns, irregular AMRs, reduced loudness

Question 13

Speech findings: AOS (8)

Answer 13

Poorly sequenced AMRs, groping, distorted substitutions, attempts at self-correction, artic additions, automatic > volitional, inconsistent errors, increased errors with length

Question 14

Supratentorial lesions (cerebrum, BG, thalamus) (5)

Answer 14

Spastic, hypokinetic, hyperkinetic, UUMN, AOS

Question 15

Posterior fossa lesions (pons, medulla, midbrain, Cb) (5)

Answer 15

Flaccid, spastic, ataxic, hyperkinetic, UUMN

Question 16

Spinal peripheral lesions (1)

Answer 16

Flaccid

Question 17

Can aphasia mask AOS?

Answer 17

Yes. Disproportionately poor verbal scores. Associated with posterior frontal or insular lesions

Question 18

Differences between apraxic and aphasic (phono) speech errors?

Answer 18

Apraxic speakers will recognize errors. Apraxic errors are more consistent in location and type, closer to target.

Question 19

Breathiness, diplophonia, hypernasality, audible nasal emission, audible inspiration, short phrases, rapid deterioration and recovery with rest, speaking on inhalation

Answer 19

Flaccid

Question 20

Harshness, low pitch, slow rate, strained-strangled, pitch breaks, slow/regular AMRs

Answer 20

Spastic

Question 21

Irregular articulatory breakdowns, irregular AMRs, distorted vowels, excess loudness variation, telescoping syllables,

Answer 21

Ataxic

Question 22

Monopitch, reduced loudness, reduced stress, monoloud, inappropriate silences, short rushes of speech, variable rate, increased rate in segments, increased overall rate, rapid and blurred AMRs, repeated phonemes, palilalia

Answer 22

Hypokinetic

Question 23

Slow and irregular AMRs, distorted vowels, excess loudness variation, sudden forced inspiration/expiration, prolonged intervals, voice stoppages, transient breathiness, voice tremor, myoclonus, intermittent hypernasality, deterioration with increased rate, inappropriate vocal noises, coprolalia

Answer 23

Hyperkinetic

Question 24

Slow rate, irregular artic breakdowns, irregular AMRs, reduced loudness

Answer 24

UUMN

Question 25

Poorly sequenced AMRs, groping, distorted substitutions, attempts at self-correction, artic additions, automatic > volitional, inconsistent errors, increased errors with length

Answer 25

AOS