lecture 11- differential diagnosis

Question 1

which disorders are associated with LMN

Answer 1

flaccid dysarthria

Question 2

which disorders are associated with UMN

Answer 2

spastic dysarthria

Question 3

which disorders are associated with Cerebellum

Answer 3

ataxic dysarthria

Question 4

which disorders are associated with subcortical structures

Answer 4

hyperkinetic and hypokinetic dysarthrias

Question 5

which disorders are associated with vascular

Answer 5

UUMN and flaccid dysarthria

Question 6

Flaccid dysarthria OME Pearls

Answer 6

• atrophy and fasiculations (not always seen but not see in any others)
• hypotonia and hyporeflexia (can be seen in others such as ataxic dysarthria but are more common and pronounced in flaccid)

Question 7

Flaccid dysarthria Speech Pearls

Answer 7

phonatory and resonators abnormalities are the most distinguishing

• breathiness, diplophonia, audible inspirations
• breathiness in hypokinetic dysarthria can be difficult to distinguish from flaccid
• hypernasality, nasal emissions, and nasal snorting

Question 8

Spastic dysarthria OME pearls

Answer 8

pathological oral reflexes, hyperactive gag, pseudo bulbar affect

Question 9

Spastic Dysarthria Speech Pearls

Answer 9

slow speech rate, slow and steady AMRs, strained quality, sometimes accompanied by hypernasality (more pronounced in flaccid)

Question 10

Ataxic Dysarthria OME pearls

Answer 10

normal findings

jaw, face, and lingual moments often dysmetric

Question 11

Ataxic Dysarthria Speech pearls

Answer 11

irregular arctic breakdowns during connected speech

-irrefular AMRs and dysprosody

Question 12

Hypokinetic Dysarthria OME

Answer 12

• facial masking
• orofacial temulousness
• reduced ROM on non speech AMR

Question 13

Hypokinetic Dysarthria speech

Answer 13

mono pitch, monoloundness, reduced loudness and stress, rapid rate
-rapid and blurred AMRs

Question 14

Hyperkinetic Dysarthria OME

Answer 14

quick or slow, patterned or unpatterned involuntary movements at res, during sustained posture, or AMR
-some hyperkinesis occur only during speech

Question 15

Hyperkinetic Dysarthria Speech

Answer 15

visual observation is most useful

helps to distinguish it from the irregularity seen in ataxic dysarthria

Question 16

UUMN Dysarthria- OME

Answer 16

unilateral lower facial weakness or unilateral lingual weakness without atrophy or fasiculations
-unilateral also seen in flaccid

Question 17

UUMN - speech

Answer 17

mildness, imprecise speech, regular AMR with some irregularity during connected speech