SPASTIC DYSARTHRIA Flashcards
NEURAL BASIS OF SPASTIC DYSARTHRIA
Bilateral damage to upper motor neurons
left and right tracts of pyramidal and extrapyramidal systems
Pyramidal system:
weak and slow skilled movements mostly tongue and lips
reduced range of movements
Extrapyramidal system:
weakness
increased muscle tone (spasticity, mostly in laryngeal muscles)
abnormal reflexes
Freed, 2020
CAUSES OF SPASTIC DYSARTHRIA
Name a degenerative cause
Any injury resulting in
bilateral damage to upper motor
neurons of pyramidal and
extrapyramidal systems
Strokes
Degenerative diseases
Amyotrophic Lateral Sclerosis (ALS) 22
months life expectancy
Eventually – mixed dysarthria
Traumatic head injury
Pyramidal and extrapyramidal tracks
Infections of brain tissue
Multiple Sclerosis–immunologic disorder,
inflammation or destruction of myelin
sheath covering axons
Tumors
Brainstem tumor
Cerebral anoxia
Brain damage due to limited oxygen in blood
Freed, 2020
Spasticity
Spasticity
The resistance due to not being
able to relax and stretch the
muscle
High muscle tone
Rigidity
Rigidity –slowness of motion
Appears weak due to resistance to
stretching
Pseudobulbar Palsy vs bulbar Palsy
Pseudobulbar Palsy –Spastic bilateral
cortical Bulbar Palsy is LMN disorder
Speech Characteristics
Errors
Speech errors in spastic dysarthria
Spasticity
Slowness
Limited Range of motions
Weakness in vocal-tract muscles
Articulation
phonation
resonance
prosody
respiration is affected minimally
Articulation Characteristics
Articulation
Imprecise consonant production
Abnormally short voice onset time for voiceless consonants
Abnormal articulatory contact
Problems with consonant clusters
Vowel distortions
Phonation Characteristics
Phonation
Harsh vocal quality
Air escapes through partially open vocal folds during phonation
Strained-strangled vocal quality,
Loud voice
Tight hyperadduction of vocal folds
Low pitch
increased muscle tone in larynx
Resonance Characteristics
Hypernasality
Spasticity in velar muscles slows and reduces range of soft palate movement causing incomplete
velopharyngeal closure during nonnasal speech sounds
Not as severe as in flaccid dysarthria
Nasal emission is rare
Freed, 2020
Prosody Characteristics
Prosody
Monopitch
Tension in laryngeal muscles results in reduced ability to contract and relax to
vary pitch
Monoloudness
Increased muscle tone in laryngeal muscles
Slow rate
Respiration Characteristics
Respiration
Abnormal respiratory movements are rare
Reduced inhalation and exhalation
Uncoordinated breathing patterns
Reduced vital capacity
Freed, 2020
Additional Characteristics
Pseudobulbar affect
Uncontrollable crying or laughing that can accompany damage to upper motor
neurons of brainstem
damage to part of brain which inhibits emotions
Drooling
Impaired oral control of saliva or less frequent swallowing
Dysphasia
Paresis/spasticity of other body parts
Hyperactive reflexes
e.g., gag
Pathologic reflexes
e.g., suck, Babinski
Spastic Dysarthria
Hypernasality
Voice
Hyperreflexes
Distinctive signs
Spastic Dysarthria
Bilateral damage to upper motor neurons of pyramidal
and extrapyramidal systems
Hypernasality
Not as severe
No nasal emission
Voice
Tight, strained-strangled voice
Hyperreflexes
Distinctive signs
Pseudobulbar palsy
Slow rate combined with
Harsh or strained-strangled voice
Reduced pitch and loudness variability
Doesn’t have normal stress
No rising/falling intonation
Pseudobulbar affect and drooling
Dysphagia
Flaccid Dysarthria
Hypernasality
Voice
Hyperreflexes
Distinctive signs
Flaccid Dysarthria
Damage to lower motor neurons
Hypernasality
Nasal emission
Voice
Breathy voice
Absent or weak reflexes
Distinctive signs
Bulbar palsy
Atrophy and weakness in muscles of tongue,
velum, larynx, and pharynx
Atrophy due to lack of innervation
Continuous breathiness
Stridor Freed, 2020
