Spastic Dysarthria

  1. Spastic Dysarthria (often mixed with another dysarthria)
    • perceptually distinct, it is produced by bilateral damage to the IAP and the DAP of the CNS
    • -really effortful
    • -weakness+spasticity=UMN disease
    • -excessive muscle tone and weakness of speech
    • -a problem of neuromuscular execution
    • -multi lesions bilaterally
  2. DAP (skilles discrete movements) Lesions
    • disruption of messages to the FCP
    • -unilateral UMN lesions do not really have an effect on jaw, velopharyngeal, laryngeal or lingual speech movements
    • -loss of fine skilled movements, hypotonia, weakness (bilateral lesions)
  3. IAP (reflexes posture tone: Inhibitory) Lesions
    increased muscle tone, spasticity, clonus (repetitive reflex contraction), posture, hyperactive stretch reflex, babinski sign, hyperactive gag refelx
  4. spastic paralysis
    spasticity, weakness, ROM, slowness of movement
  5. Etiologies of Spastic
    • TBI
    • PLS (early ALS but confined to the UMN)
    • Spastic CP
    • Vascular disorders (must be bilateral)
    • inflammatory disease
  6. speech characteristics:
    • -Strained harsh voice quality
    • -monopitch monoloudness, slow rate and slow and regular AMRs
    • -hyperadduction of the vocal folds
    • -hypernasality
  7. clinical characteristics
    • -dysphagia, drooling, weak face and tongue, pseudo bulbar affect
    • -reflexive or emotional facial expressions are slow
    • -Range is limited, force is reduced, tone is excessive
  8. Patient perspectives
    • slow and effortful speech
    • -difficulty swallowing
    • -fatigue
    • -over active gag reflex
    • -difficulty controlling expression of emotion
  9. OME findings
    • jaw strength is normal
    • face weak bilaterally
    • lips reduced rom bilaterally
    • tongue reduced rom and strength
    • AMRs slow and reduced rom
    • cough and coup may be weak
    • jaw jerk is common
  10. Spastic vs Flaccid
    • spastic-bilateral UMN, strangled harsh voice
    • flaccid- LMN, hypernasality more severe, nasal emissions, breathy voice
  11. treatments
    • -medication to help with spasticity
    • -PBA=medications or BM
    • -pitch range exercises
    • -resonance exercises
    • -relaxation techniques
    • -muscle strengthening
    • -contrastive stress drills
Card Set
Spastic Dysarthria
Spastic Dysarthria