Dysphagia refers
to speech problems that are caused by the muscles involved with speaking
or the nerves controlling them. Both muscle weakness and incoordination
can give rise to dysarthria. Speech problems that result from cognitive
dysfunction are not dysarthria.
Dysarthria is a feature
of many neurological diseases including cerebral palsy, stroke, traumatic
brain injury, Parkinson’s disease, Amyotrophic Lateral Sclerosis (ALS)
and multiple sclerosis.
Dysarthria is a relatively
common symptom of multiple sclerosis and can take many forms. Episodic
paroxysmal dysarthria, which is where the dysarthria lasts for up to a minute
or so and recurs several times a day, is particularly common in MS.
Dysarthria can be
caused by dysfunction in the nervous pathways affecting any of the muscles
of the tongue and mouth, the voice box and the respiratory system. In multiple
sclerosis it is often caused by lesions in the
cerebellum, the
brainstem
or connecting pathways.
There are four main
types of dysarthria:
Dyskinetic dysarthria,
which can either be hyperkinetic leading to problems with speech rate and
rhythm or hypokinetic which results in poor articulation and slurred speech.
Spastic dysarthria which
is spasticity of the muscles involved in speech and gives rise to a lot
of problems with speech depending on the affected muscles.
Peripheral dysarthria which affects the airflow of speech and results in distorted consonants and speaking in short phrases.
Mixed dysarthria which results from dysfunction in more than one speech motor system.
There are no drug treatments
for dysarthria but speech therapy can be of great benefit.
A number of strategies
can be used to deal with the effects of dysarthria including:
Reduce any background
noise in the room.
Facing the person you
are talking to.
Using short simple phrases
rather than long complicated ones.
Demand and take the
time to say what you have to - don't be rushed.
Make extra use of body
language such as gestures and facial expressions.
Use writing as well
as speaking.
Don't make a big deal
of saying things correctly - if the basic message that you are trying to
convey is understood then that is enough.
