Motor Speech Exam 4: Mixed Disorders Overview

What are mixed disorders in motor speech?

Mixed disorders involve multiple system involvement, affecting nerves, cerebellum, and/or cortex, resulting in various types of apraxias or dysarthrias in one individual.

What is the mechanism of Amyotrophic Lateral Sclerosis (ALS)?

ALS involves degeneration of upper and lower motor neurons, which may start with either upper motor neurons (UMN) or lower motor neurons (LMN) and progress to both.

What is the prognosis for ALS?

The prognosis for ALS is progressive and terminal within 2-5 years, with potential progression to fronto-temporal dementia (FTD-ALS).

What type of speech disorder is associated with ALS?

ALS typically presents with mixed spastic-flaccid dysarthria, but the presentation can be highly variable.

What is the mechanism of Multiple Sclerosis (MS)?

MS is characterized by demyelination of the central nervous system (CNS), which can also affect the peripheral nervous system (PNS), particularly cranial nerves.

What is the prognosis for Multiple Sclerosis (MS)?

The prognosis for MS is variable, often occurring in 'attacks' but can also be monotonically progressive, with symptoms changing over time.

What type of speech disorder is typically seen in MS?

MS typically presents with spastic-ataxic dysarthria, but the presentation is highly variable, leading to its nickname as a 'snowflake' disease.

What is the mechanism of Multisystem Atrophy (MSA)?

MSA involves neurodegeneration affecting multiple systems, with types including Parkinsonian (MSA-P) and Cerebellar (MSA-C).

What is the prognosis for Multisystem Atrophy (MSA)?

The prognosis for MSA is progressive.

What type of speech disorder is associated with Multisystem Atrophy (MSA)?

MSA can lead to mixed hypokinetic-ataxic-spastic dysarthria, depending on the type.

What is the mechanism of Cerebral Palsy (CP)?

CP is caused by congenital or perinatal brain injury.

What is the prognosis for Cerebral Palsy (CP)?

The prognosis for CP is non-progressive but lifelong.

What types of speech features can be present in Cerebral Palsy (CP)?

Speech in CP can present with spastic, dyskinetic, and/or ataxic features, often in a mixed presentation.

What are the effects of a stroke on speech?

The effects of a stroke on speech are variable and depend on the location of the stroke, potentially leading to spastic dysarthria.

What is the mechanism of Traumatic Brain Injury (TBI)?

TBI involves diffuse axonal injury and focal lesions.

What is the prognosis for Traumatic Brain Injury (TBI)?

The prognosis for TBI is variable.

What type of speech disorder is commonly seen after TBI?

TBI commonly results in mixed dysarthria, which can be spastic, flaccid, or ataxic.

What is Friedreich's Ataxia (FRDA/FA)?

FRDA is an inherited degeneration of the spinal cord, peripheral nerves, and cerebellum.

What is the prognosis for Friedreich's Ataxia (FRDA/FA)?

The prognosis for FRDA is progressive.

What type of speech disorder is associated with Friedreich's Ataxia (FRDA/FA)?

FRDA primarily presents with ataxic speech, which can be mixed with spastic features.

What is Spinocerebellar Ataxia (SCA)?

SCA is a genetic degeneration affecting the cerebellum and other CNS structures.

What is the prognosis for Spinocerebellar Ataxia (SCA)?

The prognosis for SCA is progressive.

What type of speech disorder is associated with Spinocerebellar Ataxia (SCA)?

SCA primarily presents with ataxic speech, with mixed presentations possible depending on the subtype.

What is Progressive Supranuclear Palsy?

Progressive Supranuclear Palsy involves degeneration of the basal ganglia, UMN, and cerebellum.

What is the prognosis for Progressive Supranuclear Palsy?

The prognosis for Progressive Supranuclear Palsy is progressive.

What type of speech disorder is associated with Progressive Supranuclear Palsy?

This condition typically leads to mixed hypokinetic-spastic dysarthria.

What is the mechanism of Corticobasal Degeneration/Syndrome?

Corticobasal Degeneration involves neurodegeneration affecting the cortex and basal ganglia.

What is the prognosis for Corticobasal Degeneration/Syndrome?

The prognosis is progressive, typically lasting 1-8 years post onset.

What type of speech disorder is associated with Corticobasal Degeneration/Syndrome?

This condition presents with spastic-hypokinetic dysarthria.

What is Chronic Traumatic Encephalopathy (CTE)?

CTE is caused by repetitive brain trauma.

What is the prognosis for Chronic Traumatic Encephalopathy (CTE)?

The prognosis involves progressive cognitive and motor decline.

What are common etiologies for aphasia in motor speech disorders?

Common etiologies include stroke (especially in the left hemisphere), Primary Progressive Aphasia (PPA), and Primary Progressive Apraxia of Speech (PPAOS).

What is neurogenic stuttering?

Neurogenic stuttering resembles developmental stuttering but occurs after brain injury or stroke, and is not responsive to typical aids.

What is echolalia?

Echolalia is the repetition of others' words or phrases, which can be full, mitigated, or ambient.

What is palilalia?

Palilalia involves repeating words already produced by the speaker, often decreasing in intensity or increasing in rate.

What is neurogenic mutism?

Neurogenic mutism is characterized by a lack of speech, which can occur in conditions like cerebellar mutism or during speech arrest.

What is (pseudo) foreign accent syndrome?

This syndrome involves a perceived foreign accent, often associated with strokes, and features vowel and consonant distortions.

What is aprosodia?

Aprosodia results from right hemisphere lesions, affecting prosody and intonation in speech.

What are treatment considerations for mixed disorders?

Treatment should be individualized based on type and severity, prioritizing intelligibility and functional communication, and may involve AAC.

What are perceptual characteristics in differential diagnosis of dysarthria?

Key characteristics include identifying predominant dysarthria features, noting patterns, and considering lesion location and disease progression.