Dysarthria

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Dysarthria
ICD-10 R47.1
ICD-9 784.5
DiseasesDB 4015
MeSH D004401

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Dysarthria is a speech disorder resulting from neurological injury, characterised by poor articulation (cf aphasia: disorder of the content of speech). Any of the speech subsystems (respiration, phonation, resonance, prosody, articulation and movements of jaw and tongue) can be affected.

Disarthic speech is due to some disorder in the nervous system, which in turn hinders control over for example tongue, throat, lips or lungs. Swallowing problems, dysphagia, are often present.

Cranial nerves that control these muscles include the facial nerve (VII), the glossopharyngeal nerve (IX), the vagus nerve (X), and the hypoglossal nerve (XII).

Classification

Dysarthrias are classified in multiple ways based on the presentation of symptoms. Specific dysarthrias include Spastic, Flaccid, Hyperkinetic, Hypokinetic, Ataxic, Unilateral upper motor neuron, and Mixed dysarthria.

Pathophysiology

The reasons behind dysarthria can be many; among the diseases are ALS, Parkinson's disease, botulism, cranial nerve lesions, chorea, prion protein related diseases, and cerebral palsy. Dysarthria can also be an early symptom of stroke, and of other forms of traumatic brain injury. More common causes are intoxication and anesthesia, although these are transient. Another possibility is myasthenia gravis.

Causes

Common Causes

Causes by Organ System

Cardiovascular Amyloidosis, Basilar artery insufficiency, Brainstem infarction , Brainstem stroke, Cardiofaciocutaneous syndrome, Cerebellar infarction , Cerebral stroke , Cerebrovascular accident, Noonan syndrome, Stroke
Chemical/Poisoning Anesthesia, Botulinum toxin, Manganese poisoning, Organophosphate poisoning
Dental No underlying causes
Dermatologic Dermatomyositis
Drug Side Effect Asenapine maleate, Carbamazepine, Cytarabine, Lacosamide, Lomustine, Loxapine, Olanzapine, Oprelvekin, Perphenazine, Pramipexole
Ear Nose Throat Enlarged tongue, Hearing loss, Macroglossia
Endocrine Amyloidosis, Hypothyroidism, Maturational delay, Woodhouse-sakati syndrome
Environmental No underlying causes
Gastroenterologic No underlying causes
Genetic Charlevoix-saguenay spastic ataxia, Mitochondrial disease, Noonan syndrome, Progressive external ophthalmoplegia, autosomal recessive, Turner syndrome, Wilson's disease, Wolfram's disease, Woodhouse-sakati syndrome
Hematologic No underlying causes
Iatrogenic Anesthesia
Infectious Disease Abscess, Anaerobic infection, Botulism, Diptheria, Guillain-barre syndrome, Lyme disease, Poliomyelitis
Musculoskeletal/Orthopedic Muscular dystrophy, Myasthenia gravis, Myotonic muscular dystrophy, Polymyositis, Progressive external ophthalmoplegia, autosomal recessive
Neurologic Acquired brain injury, Acute dystonic reaction, Alcoholic cerebellar degeneration, Amyotrophic lateral sclerosis, Anticonvulsant intoxication, Articulation disorders, Basal ganglia disorders, Basilar artery insufficiency, Botulism, Brain injury, Brain tumor, Brainstem infarction , Brainstem tumor, Brainstem stroke, Central pontine myelinosis, Cerebellar disorders, Cerebellar infarction , Cerebellar syndrome, Cerebral palsy, Cerebral stroke , Cerebrovascular accident, Charlevoix-saguenay spastic ataxia, Degenerative brain disease, Dementia, Dermatomyositis, Diabetic nerve infarction, Friedreich's ataxia, Guillain-barre syndrome, Hearing loss, Huntington's disease, Motor neurone disease, Multiple sclerosis, Muscular dystrophy, Myasthenia gravis, Myotonic muscular dystrophy, Neuroferritinopathy, Neuron lesions of cranial nerve ix, Neuron lesions of cranial nerve x, Olivopontocerebellar degeneration, Parkinson disease, Parkinsonism, Parkinson's disease, Partington x-linked mental retardation syndrome, Phonology disorders, Progressive supranuclear palsy, Resonance disorders, Spinocerebellar ataxias, Wilson's disease, Worster-drought syndrome
Nutritional/Metabolic Diabetic nerve infarction, Neuroferritinopathy
Obstetric/Gynecologic No underlying causes
Oncologic Brain tumor, Brainstem tumor
Ophthalmologic No underlying causes
Overdose/Toxicity Alcoholic cerebellar degeneration, Anticonvulsant intoxication
Psychiatric Psychologic disorders
Pulmonary No underlying causes
Renal/Electrolyte Central pontine myelinosis
Rheumatology/Immunology/Allergy Amyloidosis, Polymyositis
Sexual No underlying causes
Trauma Abscess, Head injury, Head trauma, Hearing loss, Poorly fitting mouth appliances
Urologic No underlying causes
Miscellaneous No underlying causes

Causes in Alphabetical Order


Treatment

The articulation problems that dysarthria causes can be treated together with a speech language pathologist using a range of techniques which sometimes includes strengthening the speech musculature. Devices that make coping with dysarthria easier include speech synthesis software and text-based telephones.

References


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