Neurogenic Speech Disorders

Motor Speech disorder ( MSD)

group of speech difficulties , motor/movement problems as a result of neoruolgical injury ( caused by stroke, TBI, brain tumors, infection and toxins, diseases

Cerebral palsy (CP)

Heterogenous group of neurological problems as a result of brain injury and which occurs very early in development ( pre, peri, or post natally)

3 features that differentiate CP from Others Neurogenic SDs

(1) developmental disorder

(2) not a disease, non progressive, non infectious injury

(3) motor patterns are more predictable than those in acquired neurogenic disorders ( all limbs affected in the same way)

Spastic CP

60% of cases, hypertonia ( increased muscle tone)/ rigidity, infantile reflex patterns ( rooting)

Athetoid CP

30% of cases, slow involuntary writhing movements

Ataxic CP

10% of cases, uncoordinated movement, disturbed balanced, clumsy/awkward, injury to the cerebellum

Anoxia

common causes of CP, loss of o2 supply to the brain

Hemorrhage

common cause of CP, blood flow in the brain is interupted due to a ruptured aneurysm

Management of CP

Team approach ( pediatrician, SLP, PT, ENT, OT, Special Ed teacher, Audiologist, social worker, opthamologist, psychologist

Dysarthria

group of speech impairments that result from disturbed muscle control caused by damage ro the mature nervous system. Disturbance in more than one speech subsystem ( speed, range, direction, stregth, timing, coordination), can result in paralysis, weakness, or discordination of muscle movements

Flaccid Dysarthria

hypotonia ( weak, soft, flabby tone), weakness of paralysis of the affected muscle, diminished reflexes

Spastic Dysarthria

hypertonia, stiff and rigid muscles, hyperactive reflexes, weakness

Ataxic Dysarthria

coordination problems (With hypotonia), errors in accuracy, timing, and direction of movements; jerky and imprecise movements, overshooting targets. Damage to the cerebellum causes breakdown in motor organization.

Hypokinetic Dysarthria

muscle rigidity, bradykinesia, major cause is parkinson's disease

Bradykinesia

slowness of movement

Parkinsons Disease

progressive, cause unknown, masked face, resting treor, dyskinesias, involuntary movements

Hyperkinetic Dysarthria

involuntary movements, caused by Huntingtons Chorea (inherited progressive disease)

Mixed Dysarthria

mixture of two or more pure dusarthrias, main cause is Amgotrophic lateral sclerosis (ALS, Lou Gehrig s Disease) → rapidly progressing degenerative disease, cause unknown, flaccid spastic mixed dysarthria

Apraxia of Speech

disorder of volitional movement and sequencing that is unrelated to muscle weakness , slowness of paralysis

→ disorder of motor programming(organzing and planning)

→ etilogy : lesions in the central programming area for speech (Brocas area,but there may be other lesion locations)

Clinical characteristic of AOS

Auditory processing is typically well preserved ( leading to awareness of speech difficulties → frustration due to struggle of self self correction ( most salient speech characteristics; articulation, rate, and prosody difficulties)

→ straining for correct articulatory posture, inconsistent articulatory errors, may in severe cases be mute or produce stereotypic phrases