Dysarthria

Dysarthria refers to the disability for articulating words correctly. It is the condition in which the words spoken by the affected individual would sound breathy, jerky, irregular, imprecise, or dull. Many people misinterpret dysarthria as a language problem. However, it is a disorder related to muscles that are involved in speaking.

Actually, the various muscles of your body such as tongue, lips, vocal cord, and diaphragm are involved in speaking. To speak out a clear word, it is necessary that all these muscles are healthy and work optimally. In case any of these muscles would not work well or is weak, the spoken word would not be clearly audible to the correspondents of the speaker.

Additionally, a part of your brain is involved in controlling and providing a coordination between all such muscles. In case this part is also not operating expectedly, the individual would not be able to speak properly. Dysarthria is a disorder in which the portion of the patient’s brain, which is involved in controlling all the muscles involved in speaking, would not work well.

The level of lack of clarity of the patient’s speech depends on the severity of this disease. For instance, some individuals suffering from dysarthria may face minor problems in speaking words. However, some of them may find it very difficult to speak even the shorter words correctly. This severity further depends on the level of inoperability of the brain’s part responsible for coordinating the muscles involved in speaking.

Irrespective of the severity of this disorder, you must visit a physician or a speech therapist at the earliest with any such symptom. If not treated on time, dysarthria may result in complete loss of speech. This extensive state of dysarthria is called as anarthria. Many individuals also misinterpret dysarthria with aphasia, which is the condition of difficulty in understanding words by the patient.

Whereas, dysarthria is only related to the unintentional incorrect pronunciation of words. Both the causes and symptoms of these two disorders may be different. Even then, an individual may suffer from both dysarthria and aphasia at the same time. Also, note that the speech syndromes caused due to structural abnormalities of the body parts do not come under dysarthria. Those are called as cleft palate.

Dysarthria could be of the following types:

-  Flaccid Dysarthria: Caused by the disorder of lower motor neurons or muscles.

-  Spastic Dysarthria: Caused by the disorder of bilateral upper motor neurons.

-  Ataxic Dysarthria: Caused by the disorder of cerebellar controlling unit.

-  Hypokinetic Dysarthria: Caused by the lack of basal ganglia controlling unit.

-  Hyperkinetic Dysarthria: Caused by the excess of basal ganglia controlling unit.

-  Unilateral (Upper Motor Neuron) Dysarthria: Caused by the disorder of unilateral upper motor neurons.

-  Mixed Dysarthria: Caused by the combinational disorders of multiple types of dysarthria, such as Spastic – Flaccid, Ataxic – Spastic, and more.

-  Undetermined Dysarthria: The symptoms are of dysarthria. However, the actual type of dysarthria could not be identified.

Dysarthria Symptoms:

The primary symptom of dysarthria include inability to speak proper words. The sub-symptoms may, however, vary based on the subsystems due to which the disorder is caused. These subsystems include phonation, respiration, articulation, prosody, and resonance. The various audible sub-symptoms associated with these subsystems are mentioned below:

-  Phonation

- Pitch level is either very low or very high

- Breaks in the voice pitch

- Mono-pitch

- Deviant voice quality with the traces of breathiness, roughness, strain, and harshness

- Vocal flutter

- Voice shake

- Voice interruption

- Inhalation sound along with words

- Sound at the end of each phrase or sentence

-  Respiration

- Short phrases

- Lower loudness of voice

- Mono-loudness

- Variation with excessive loudness

- Decay of voice with loudness

- Forced finishing of words

-  Articulation

- Vague pronunciation of consonants

- Distorted pronunciation of vowels

- Uneven articulatory failure

- Articulatory blurriness

-  Prosody

- Abnormal rate of such as very fast, very slow, accelerating or variable

- Rush of speech

-  Reduction in stress on words while speaking

- Excessive stress on words while speaking

- Prolonged interval between the words than usual

- Inappropriate silence between the words

-  Resonance

- Over nasality while speaking

- Denasality or oral resonance of nasal consonants

- Nasal emission or snort while speaking

Else than the above, the various physical symptoms observed by the patients of dysarthria are mentioned below:

-  Muscle numbness

-  Unusual muscle behaviour even at rest

-  Fasciculation

-  Tremors in jaws, head, lips, tongue, and velum

-  Weakness in tongue, lower part of the face, and velum

-  Sensations or movements in the jaws, head, tongue, face, and velum

-  Irregular reflexes such as jaw jerks, suck, snout, and more

Causes of Dysarthria:

Dysarthria is primarily caused due to various types of disorders related to the nervous system. Those may include brain injury, stroke, brain tumour, facial paralysis, tongue paralysis, weakness of throat muscles, and more. Additionally, consumption of various types of medicines may also cause dysarthria. Other than that, it may be caused by various acute, chronic or congenital ailments. Some of those are mentioned below:

-  Congenital diseases such as chiari malformation, cerebral palsy, suprabulbar palsy, syringobulbia and syringomyelia

-  Degenerative diseases such as Parkinson's disease, amyotrophic lateral sclerosis, progressive supranuclear palsy, corticobasal degeneration, cerebellar degeneration, multiple system atrophy, Huntington's disease, Friedreich's ataxia, olivopontocerebellar atrophy, ataxia telangiectasia and spinocerebellar ataxia

-  Inflammatory diseases such as encephalitis, multiple sclerosis, Guillain-Barré, autoimmune diseases, multifocal leukoencephalopathy and meningitis

-  Infectious diseases such as Creutzfeldt-Jakob disease, Acquired Immune Deficiency Syndrome (AIDS), herpes zoster, nervous system tuberculosis, infectious encephalopathy and poliomyelitis

-  Neoplastic diseases such as cerebral, brainstem tumour and paraneoplastic cerebellar degeneration

-  Neurologic diseases and conditions such as Meige syndrome, hydrocephalus, myoclonic epilepsy, radiation necrosis, neuroacanthocytosis, sarcoidosis, Tourette's syndrome, seizure disorder and Chorea gravidarum

-  Metabolic or toxic diseases such as carbon monoxide poisoning, botulism, central pontine myelinolysis, heavy metal toxicity, botulism, hepatocerebral degeneration, hypoxic encephalopathy, hypothyroidism, Wilson's disease

-  Traumatic conditions such as brain injury, neck trauma, traumatic encephalopathy, neurosurgical trauma and skull fracture

-  Vascular diseases such as hemorrhagic stroke, Moyamoya disease, anoxic encephalopathy and arteriovenous malformation

Prevention from Dysarthria:

Since there are numerous possible reasons associated with dysarthria, so it is very tough to prevent it completely to happen. However, there are some ways and tips through which you may minimize its risk. Some of those are mentioned below:

-  Remember to get your blood pressure checked on regular basis, keep it under control, minimize the use of salt in case you are a patient of hypertension

-  Try to keep your sugar levels in prescribed limits, especially when you are a patient of diabetes

-  Avoid consumption of junk food items like burger, pizzas, and more as those may up rise the cholesterol in your bloodstream

-  Stop smoking

-  Minimise the use of aspirin, if possible, even if prescribed by the doctor

-  Keep the symptoms of chronic disorder in control

-  Minimise the alcohol consumption

-  Exercise regularly on a daily basis

-  Eat lots of fresh vegetables and fruits

-  Drink ample amount of water every day

-  Maintain a healthy weight per your Body Mass Index (BMI)

-  Use the medicines only with the prescription of your physician

-  Get regular full body check-ups done

How Dysarthria is diagnosed?

Dysarthria could be an indication of a serious disorder. Whenever you observe any unexpected change in the ability to speak words correctly, visit your physician immediately. The doctor would first physically examine you and try to assess the strength of your facial muscles. You may also be asked to perform a series of tasks that may require you to move your mouth and tongue.

The doctor may also ask you to read and repeat some words and sentences. Additionally, the amount of air inhaled by you would also be assessed. Once after examining all the symptoms and medical history, one of the following investigations may be prescribed to identify the root cause of dysarthria:

-  Magnetic Resonance Imaging (MRI) scan in which radiological pictures are captured of a body part (mainly of brain and spine) to identify the nervous system disorder if any.

-  Paroxysmal Atrial Tachycardia (PAT) diagnosis in which the chambers of the heart are assessed for any probable abnormality.

-  Computer-based tomography of the brain to identify any nerve blockage.

-  Single-photon Emission Computed Tomography (SPECT), which is an image capturing technique using a camera based on gamma rays. It helps in understanding the flow of blood through the arteries, veins, and blood vessels to the brain.

-  The patient may also be prescribed some blood and urine tests to identify the occurrence of some infection or inflammation.

-  Brain biopsy may be prescribed to the patient to identify if the symptoms are because of some brain tumour. In this test, some sample of the brain tissue is extracted and tested in the laboratory.

-  There are some other examinations specific to test dysarthria in which the swallowing process of the patient is assessed. In this test, the patient is asked to consume a special fluid, and X-ray pictures are captured at the same time. The movement of fluid from the mouth to the stomach is monitored to understand if it is taking much time than expected.

-  The nerve conduction and electromyogram tests may also be prescribed to check the muscle or nerve functioning of the patient’s body.

Treatment of Dysarthria

As already discussed that dysarthria is caused by one or more of multiple other diseases or ailments. So, the treatment of this disease contains two parts. Firstly, when the cause of dysarthria is identified through the medical investigations, the doctor would provide the patient with the treatment of the root problem.

This way, the symptoms of dysarthria would be stabilized. For example, if dysarthria is caused to the patient due to some medication, it is either changed by some suitable medicine or is discontinued. Then if it is because of hypertension, the patient is provided with the treatment for keeping the blood pressure under control. Rest then that the symptoms of dysarthria are also treated so that the patient will be able to speak properly as earlier.

Note that the primary treatment for improving the speech of the patient is through speech therapy. The level of improvement, however, may vary from patient to patient. The speech therapist may teach the patient the following tasks in order to improve the speech:

-  Specific exercises for strengthening the muscles of jaws, tongue and mouth

-  New and effective alternative ways to speak clearly and easily, like to talk a bit slowly or to pause in between to have control over the breath

-  The breathing techniques for controlling the loudness of the voice

-  Several devices may be used for improving the sound of the patient’s voice, such as a voice amplifier

-  Several communication improvement tips may also be taught to the patient, such as to:

-  Avoid speaking at noisy places (such as a restaurant or market)

-  Turn off the TV before speaking

-  Use face expression or hand gesture to express your thoughts

-  Use short phrases and words to convey your point

-  The family members of the patients are also educated to cooperate and encourage them in coping-up with the symptoms

Complications

Since dysarthria causes difficulty in speaking clearly, its patient may face multiple challenges related to communication in day to day life. With this, the patient may start isolating with the society, friends, relatives, colleagues, and even the family members. It has been observed that such isolation may result in the patient to face depression. Therefore, it is very important for the family and close friends of such patients to support them and motivate to the symptoms are improved.

Myths Related to Dysarthria

Myth #1: Dysarthria may occur only to the intelligent individuals

Dysarthria is a common symptom caused by multiple other diseases and factors. It has nothing to do with the intelligence level of an individual.

Myth #2: Dysarthria affects the hearing ability

Dysarthria causes only the speaking disorders, it never affects the hearing power of the patient.

Myth #3: The only cause of dysarthria is a stroke

There are lots of reasons due to which an individual may suffer from dysarthria. Stroke is just one of those.

Myth #4: Dysarthria could not affect the teenagers

This is not necessary. Dysarthria can affect individuals of any age.

Last updated on : 14-09-2018

Disclaimer : Docprime doesn’t endorse or take any guarantee of the accuracy or completeness of information provided under this article and these are the views strictly of the writer. Docprime shall not be held responsible for any aspect of healthcare services administered with the information provided on this article.

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