Contents
What is dysarthria?
Dysarthria is the difficulty in articulating speech caused by neurological reasons. The person cannot move his mouth correctly to intone the words, which are not formed.
Because it is a motor disease , the disease affects only the patient’s articulation and speech and not language. Their comprehension and writing skills are preserved.
Types
Different types of dysarthria are caused by different types of injuries or illnesses. Symptoms vary from type to type and may have slurred, rapid speech, between teeth, very high or low, among others. The types are:
Flaccid dysarthria
Caused by injury to the lower motor neuron , this type of dysarthria is often accompanied by a hoarse voice and decreased voice strength. Other characteristics are consonants sounding inaccurate and nasal voice, in addition to loss of control of vocal frequency and accent intonation.
Disartria espástica
This version is caused by injury to the upper motor neuron . Like the flabby version, it comes with a nasal voice and inaccurate consonants, but it brings differences.
The vowels sound distorted, the voice is strangled and there is an exaggeration in the strength of the voice on the part of the patient. In addition, this version is usually accompanied by abnormal muscle reflexes and spasms.
Hipocinetic dysarthria
The so-called hypokinetic dysarthria is accompanied by a shaky and hoarse voice, little accentuation of words and a general difficulty with the articulation, which involves trembling of the lips and tongue, altered speech speed and stiffness. It can be caused by changes in the basal ganglia, parts of the brain that are related to movement.
Hyperkinetic dysarthria
As a result of hyperkinetic dysarthria , the patient’s voice becomes harsh, the vowels are articulated in a distorted way and the articulation of words is interrupted. The accent intonation is altered and there is little control over the vocal frequency. One of the main causes is damage to the ganglia at the base of the brain.
Disartria atáxica
In the ataxic version , dysarthria causes harshness of the voice, variations in accent intonation, voice of static intensity and height, slurred speech, slow and trembling lips and tongue. It is the version of the disease whose speech is similar to that of someone who is drunk.
Mixed dysarthria
In mixed dysarthria, there are changes in two or more types of dysarthria in the same patient.
Causes
Damage to the brain stem or fibers that connect the outer layer of the brain to the brain stem are causes of dysarthria, as well as problems in communication between facial muscles and nerves. Various conditions can cause this type of damage or failure. Some of them are:
Stroke
A stroke happens when the brain’s blood supply is interrupted. This can happen because of a blockage and blockage or rupture of blood vessels in the brain. Both can cause brain damage that can result in dysarthria.
Brain trauma (TBI)
Brain trauma are brain injuries caused by impact. They usually happen in sports or accidents and result, by definition, in brain damage that can cause speech disorders.
Parkinson’s disease
Parkinson’s disease is famous for the spasms it causes. These muscle spasms can cause hypokinetic dysarthria, which is characterized by spasms and tremors.
Miastenia serious
This disease is caused by a failure in the communication between nerves and muscles and it is common that it affects and creates difficulties for the patient’s speech.
Hydrocephalus
Hydrocephalus is the accumulation of cerebrospinal fluid, the fluid that protects the brain and spinal cord from impacts in the cranial cavity. If there is too much fluid, there is an increase in brain pressure, which can cause several diseases.
Korea
Korea, or weeping, is not a disease, but a symptom or characteristic of some diseases. It is a dyskinesia , which are abnormal, involuntary, excessive, diminished or absent muscle movements.
Examples of other dyskinesias are tics, tremors or restless legs. Chorea is characteristic of diseases such as Huntington’s disease , the Wilson’s disease , the neuroacanthocytosis , among others.
The movements created by Korea are brief, irregular, semi-rigid and unrhythmic, which can result in dysarthria.
Narcotics or tranquilizers
Medicines that affect the central nervous system (CNS) are capable of causing temporary or chronic dysarthria.
Brain tumors
Brain tumors are able to affect any area of the brain and each affects the body differently. If the tumor grows in the motor area, it can cause dysarthria, in addition to other motor problems.
Amyotrophic lateral sclerosis (ALS)
This condition gained prominence after the ice bucket challenge in 2014, which sought to promote awareness about the disease. It affects the central nervous system (CNS) and causes progressive weakness of the muscles.
Astrophysicist Stephen Hawking has the disease and, before completely losing his speech to a severe pneumonia that led to emergency tracheostomy, he faced dysarthria caused by ALS.
Multiple sclerosis
This disease can cause demyelination – the loss of the myelin sheath of neurons – of the cranial nerves, as well as in the brain stem. This damage can cause motor difficulties that lead to dysarthria.
Infections
Infections that affect the central nervous system (CNS) can be the cause of dysarthria and other neurological problems.
Cerebral palsy
The cerebral palsy is a result of abnormal development of the brain and can cause a dysarthria.
Streaming
Dysarthria is not a disease that can be transmitted from person to person. Anyone can contract it at any time, it is enough that a lesion in the correct part of the brain happens for the motor speech difficulty to set in.
Risk factors
Risk factors for dysarthria include:
Abuse of alcohol and other drugs
Abuse of alcohol and other drugs can lead to neurological diseases, many of which are causes of dysarthria. Lack of control over substance use puts anyone at risk for dysarthria and several other neurological diseases.
Neuromuscular diseases
Diseases such as myasthenia gravis, which cause problems in the communication between nerves and muscles, are risk factors for dysarthria.
Neurodegenerative diseases
Neurodegenerative diseases such as multiple sclerosis evolve gradually, affecting different regions of the central nervous system. Dysarthria is caused by the disease reaching the CNS, which ends up causing dysarthria.
Brain tumors
It is possible for a tumor to develop into a condition that affects the motor area of the brain, which can lead to dysarthria.
In the stroke risk group
Diabetes , history of stroke, hypertension, smoking , obesity , brain tumors, excessive drinking or drugs, old age, stress and anything else that can contribute to a stroke is also a risk factor for dysarthria.
Symptoms
Among the symptoms of dysarthria are:
Distorted speech
Speech distortions are the main symptom of dysarthria. Speech can have several modifications such as hoarse sound, speech that is too slow or fast, murmured, too loud, whispered, distorted vowels and consonants, variations in accent intonation and lack of articulation of words.
Each type of dysarthria has its own variations in speech symptoms, but in general they are impediments and difficulties in intonation and articulation. The sound comes out of the patient’s mouth according to the words that are meant, but the joint, the muscular part, does not allow the words to be clear and to form correctly.
Baba
Due to lack of control over facial muscles, drooling is a common symptom of dysarthria.
Difficulty in chewing and swallowing
It is possible that the patient will not be able to chew and swallow food properly due to weakness or lack of control of the muscles of the mouth.
Difficulty in facial muscle movement
The muscles of the face may have difficulty moving because of impaired communication of the facial nerves with the brain.
How is dysarthria diagnosed?
The diagnosis of dysarthria is made by a general practitioner, speech therapist or neurologist . Identifying dysarthria is easy, but the doctor may ask the patient to perform some tasks to measure the intensity of the dysarthria. He can:
- Ask the patient to make different sounds;
- Ask the patient to recite the days of the week or to count;
- Talk about any subject;
- Read aloud.
During all these examinations, he will observe the muscular movement of the mouth and larynx.
Although diagnosing dysarthria is not difficult, what really matters in this diagnosis is to discover its cause. Dysarthria never comes out of the blue and its cause is the key to understanding why it is happening and what to do about it.
The doctor may order the following tests to find the cause:
Electroencephalogram
This test measures electrical activity in the brain and is able to identify what part of it is causing a patient’s symptoms.
Magnetic resonance and computed tomography
These scans are known as imaging scans and can create a detailed image of the brain, allowing damaged parts to be identified.
Lumbar puncture
Lumbar puncture can be used to identify pathogens that are affecting the brain, in addition to being able to be used in conjunction with neuropsychological assessment.
Neuropsychological assessment
They identify which brain functions (understanding speech, reading and writing comprehension, reasoning speed) are preserved or altered, as well as telling which areas of the brain may be causing symptoms. Neuropsychological assessments are applied by neuropsychologists .
Brain biopsy
If a tumor is suspected, the doctor may order a sample of brain tissue to perform a test.
Nerve conduction study
This type of examination measures the speed and strength of electrical signals from the nerves to the muscles.
Blood and urine test
These tests can find infections and contamination that may be causing dysarthria.
Once the cause is discovered, treatment can be suggested.
Is dysarthria curable?
Depending on the cause, dysarthria can be cured. In some cases, it is permanent and can only be treated to relieve your symptoms.
As dysarthria is always caused by some other disease or condition, the cure of the problem depends on the possibility of curing the cause.
What is the treatment?
Treating dysarthria is treating the cause of the disease. After taking the exams and having the results, you can know what needs to be done.
Surgery
Some diseases that cause dysarthria can be resolved with surgery. It is the case of tumors, which can be removed and stop affecting certain areas of the brain.
Specific medication for the cause
Parkinson’s disease, for example, can cause dysarthria. Medicines that relieve your symptoms, as well as those of other illnesses, can be used to reduce communication failures.
Speech therapy treatment
In any of the cases of dysarthria, it is possible to do language exercises that aim to correct speech. There is no guarantee that they will correct the patient’s speech problems, but it is an option that can give satisfactory results. The speech therapist applies these exercises .
Speech exercises
Speech exercises can take place in several areas, based on the type of dysarthria that exists. The areas are:
- Phonation: Seeks to improve voice quality;
- Resonance: To correct the nasality of speech;
- Prosody and rhythm of speech: It seeks to correct the intonation and accentuation of speech, in addition to rhythm;
- Articulation and speech intelligibility: They seek to strengthen the muscles needed for speech activity, such as the lips and tongue, and help the patient to be able to use them efficiently, as well as other motor organs such as the mandible and the palate. ;
- Breathing: Helps with proper breathing for the best use and use of air during speech.
Alternative means of communication
Trays with letters, gestures, signs and electronic equipment can be recommended for communication in more severe cases of dysarthria.
Psychological treatment
The lack of speech can have psychological consequences for the patient. Follow-up by a psychologist can prevent or treat consequences such as depression .
Dysarthria drugs
The drugs used for dysarthria vary widely, depending on their cause, which are numerous. Some medications, such as haloperidol , can be used for some types of dysarthria because it deals with involuntary movements, but at the same time it must be contraindicated in other types, such as that caused by Parkinson’s disease or by damage to the basal ganglia.
Since dysarthria is caused by several different diseases, medications that can work for one cause may conflict with other causes or medications. Therefore, only a doctor can tell you what kind of medication each case of dysarthria can take.
Attention!
NEVER self-medicate or stop using a medication without first consulting a doctor. Only he will be able to tell which medication, dosage and duration of treatment is the most suitable for his specific case. The information contained in this website is only intended to inform, not in any way intended to replace the guidance of a specialist or serve as a recommendation for any type of treatment. Always follow the instructions on the package insert and, if symptoms persist, seek medical or pharmaceutical advice.
Prognosis
Each case is different and to say whether or not there is a cure for each specific dysarthria is a long shot. The causes of the condition can be treatable or not. Speech difficulties can disappear overnight or last a lifetime and it all depends on the type of injury, the type of disease, the treatment applied and several variables.
Speech therapy follow-up, however, is one of the safest options. Despite the various difficulties faced by the dysarthria patient, research by the American Association of Speech, Language and Hearing, approximately two thirds of adults with neurological diseases are able to increase their speech capacity after treatment with a speech therapist.
The recovery is not necessarily complete, but the increase is real and the communication skills can be recovered. The doctor and the speech therapist can have the necessary information for each case.
Living together
Having dysarthria makes communication difficult, but there are things that those who live with the disease can do to make life easier. It is a joint effort, of the one who speaks and the one who listens, so that the message is passed.
Reduce noise
Television, radio, whatever is making noises outside the conversation can impair understanding. If possible, reduce noise to a minimum.
Talk from the front
Posing face to face with the person who is speaking facilitates understanding.
Use other types of communication
A dysarthria patient’s textual understanding is not necessarily altered. The use of texts is possible and extremely valuable. In addition, it is possible to use gestures to facilitate the understanding of the interlocutor.
Avoid pointing out errors and asking for corrections
This behavior is not useful, it only causes frustration in the person who cannot speak the words correctly. Remember, the important thing is to get the message across.
Speech aid
In the most severe cases, it is possible that speech aid is needed. Letter boards and computers with electronic voices, such as the one used by Stephen Hawking, are examples of communication aids that can be used by those with severe dysarthria.
Complications
Leaving untreated dysarthria has no biological consequence. It will not be the lack of treatment that will worsen, for example. However, it has several psychological complications.
Difficulty communicating
With the difficulty of speech, comes the difficulty of communication. Living without being able to speak in an understandable way can be a challenge. Social interaction is affected and the person can isolate himself socially.
Depression
Not being able to speak can be frustrating. Over time, frustration, social isolation and challenges with poor communication can develop into depression. Therefore, it is important that there is psychological monitoring for the patient.
How to prevent dysarthria?
It is not always possible to avoid dysarthria, but you can reduce your risk factors. It is important to wear personal protective equipment when necessary to avoid injury to the head.
It is also recommended to limit alcohol, stop smoking, control diabetes and cholesterol and exercise are some of the possibilities to avoid diseases that accompany dysarthria and other even more serious consequences.
Maintaining a healthy diet, sleeping well and avoiding stress can also be good ways to maintain neurological and body health as a whole.
Dysarthria is a condition that prevents articulated speech through motor difficulties. It can cause several communication problems, in addition to almost always being accompanied by other more serious diseases. If you notice difficulty in your speech, see a doctor. Don’t forget to share this text with your friends so that they learn a little more about dysarthria!
