Neurogenic Mutism and Related Motor Speech Disorders

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Vocabulary flashcards summarizing key terms, syndromes, anatomical sites, and etiologies related to neurogenic mutism and motor-speech disorders.

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42 Terms

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Mutism

Complete absence of speech; may be deliberate, psychiatric, or neurogenic in origin.

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Neurogenic Mutism

Speech absence caused by neurological impairment (e.g., dysarthria, AOS, aphasia, cognitive-affective conditions).

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Anarthria

Speechlessness from extreme neuromuscular loss—end-stage, severe dysarthria with intact language/cognition.

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Dysarthria

Motor-speech disorder from neurological damage affecting muscular control of speech mechanisms.

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Flaccid Dysarthria

Dysarthria due to LMN damage; hypotonia and weakness—rarely results in anarthria unless multiple cranial nerves bilaterally impaired.

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Spastic Dysarthria

Dysarthria from bilateral UMN damage; strain-strangled voice, slow effortful speech—common cause of anarthria.

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Hypokinetic Dysarthria

Basal ganglia disorder (e.g., Parkinson’s); reduced loudness, rapid rate, monopitch—can progress to anarthria.

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Ataxic Dysarthria

Cerebellar disorder; irregular articulatory breakdowns, scanning speech—seldom leads to mutism.

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Hyperkinetic Dysarthria

Basal ganglia control circuit pathology; involuntary movements—rarely causes mutism.

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Mixed Dysarthria

Combination of two or more dysarthria types; most frequent pathway to anarthria in neurodegenerative disease.

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Locked-In Syndrome (LIS)

Anarthria plus quadriplegia with eye-blink/vertical gaze preserved; cognition intact, communication via eyes.

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Quadriplegia

Paralysis of all four limbs; characteristic of LIS.

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Brainstem Stroke

Common etiology for LIS with high early mortality and limited recovery.

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Biopercular Syndrome

Foix-Chavany-Marie syndrome; bilateral opercular lesions causing severe voluntary orofacial paralysis and mutism with preserved reflexive/emotional movements.

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Rolandic (Anterior) Operculum

Lower pre- and postcentral gyri region; bilateral damage causes biopercular syndrome.

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Cerebellar Mutism

Transient postoperative mutism (mainly children) after posterior fossa surgery; often evolves to ataxic dysarthria.

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Posterior Fossa

Cranial cavity region housing cerebellum & brainstem; surgical lesions here may trigger cerebellar mutism.

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Diaschesis

Loss of function in intact brain areas connected to damaged regions; proposed mechanism for cerebellar mutism.

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Traumatic Midbrain Anarthria

Mute period post-trauma with severe articulatory immobility, later mixed spastic-hypokinetic dysarthria.

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Apraxia of Speech (AOS)

Motor-programming disorder causing impaired speech sequencing; initial mutism possible post-stroke.

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Nonverbal Oral Apraxia (NVOA)

Inability to perform purposeful, non-speech oral movements; commonly accompanies AOS and mutism.

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Akinetic Mutism

Extreme abulia from mesial frontal/SMA lesions; alert but profoundly apathetic and mute.

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Abulia

Diminished motivation and initiative; milder form of akinetic mutism.

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Supplementary Motor Area (SMA)

Medial frontal cortex zone; lesions contribute to akinetic mutism and speech initiation deficits.

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Reticular Activating System (RAS)

Brainstem network governing arousal; damage may yield akinetic mutism‐like states.

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Coma

State of unresponsiveness from widespread cerebral or brainstem injury.

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Vegetative State

Wakeful unawareness following coma; preserved brainstem functions but no purposeful responses.

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Minimally Conscious State

Condition of limited but definite awareness—visual tracking, simple command following, occasional words.

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Neurogenic Stuttering

Acquired dysfluency linked to multifocal CNS lesions; differs from developmental stuttering.

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Palilalia

Pathological reiteration of one’s own speech; associated with basal ganglia/frontal damage.

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Echolalia

Automatic repetition of others’ speech; seen in diffuse or left-hemisphere lesions, dementia, etc.

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Attenuated Speech / Hypophonia

Marked reduction in voice loudness often tied to hypokinetic dysarthria or limbic/thalamic pathology.

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Disinhibited Vocalization

Involuntary outbursts (e.g., coprolalia) due to diffuse or basal ganglia lesions; seen in Tourette’s.

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Right Hemisphere Aprosodia

Impaired production/interpretation of prosodic cues for emotion or emphasis; often after RH stroke.

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Functional Speech Disorder (FSD)

Speech change of psychogenic origin; inconsistent with neurogenic patterns and often improves rapidly with suggestion.

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Primary / Secondary Gain

Psychological benefits (internal or external) that may reinforce functional symptoms.

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Corpus Callosotomy

Surgical severing of corpus callosum for seizure control; may cause transient mutism with spared comprehension.

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Ictal Speech Arrest

Transient mutism during partial seizures; resolves post-ictally.

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Myasthenia Gravis

Autoimmune neuromuscular disorder; generalized weakness—bilateral cranial nerve involvement can cause flaccid anarthria.

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Guillain-Barré Syndrome

Acute demyelinating polyneuropathy; widespread LMN weakness potentially leading to flaccid mutism.

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Wilson’s Disease

Genetic copper-metabolism disorder; basal ganglia damage may produce mixed dysarthria progressing to anarthria.

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Torus Palatinus (Tori Palatini)

Benign bony growth on hard palate; usually asymptomatic, unrelated to neurogenic speech disorders.