Dysarthria: Difference between revisions
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==Background== | ==Background== | ||
*Motor speech disorder characterized by poor articulation of language sounds or pronounciation<ref> Duffy, J. Defining, Understanding, and Categorizing Motor Speech Disorders. In: Duffy, J. ''Motor Speech Disorders: Substrates, Differential Diagnosis, and Management.'' 3rd ed. . St. Louis, Mo: Elsevier Mosby; 2012 ISBN 0323024521.</ref> | *Motor speech disorder characterized by poor articulation of language sounds or pronounciation<ref> Duffy, J. Defining, Understanding, and Categorizing Motor Speech Disorders. In: Duffy, J. ''Motor Speech Disorders: Substrates, Differential Diagnosis, and Management.'' 3rd ed. . St. Louis, Mo: Elsevier Mosby; 2012 ISBN 0323024521.</ref> | ||
*Cranial nerves involved include trigeminal nerve's motor branch (V), facial nerve (VII), glossopharyngeal nerve (IX), vagus nerve (X), and hypoglossal nerve (XII). | |||
==Clinical Features== | ==Clinical Features== | ||
*Includes abnormality to any of the following: breath control, '''duration of syllables''', pitch, range, speed, steadiness, '''timing''', tone, '''vocal quality''', pitch, volume<ref>MacKenzie, C (2011). "Dysarthria in stroke: A narrative review of its description and the outcome of intervention". International Journal of Speech-Language Pathology 13 (2): 125–36. doi:10.3109/17549507.2011.524940. PMID 21480809</ref> | |||
==Differential Diagnosis== | ==Differential Diagnosis== | ||
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===[[Weakness]]=== | ===[[Weakness]]=== | ||
'''Neuromuscular weakness''' | '''Neuromuscular weakness''' | ||
*UMN: | |||
*** [[CVA (Main)]] | ***[[CVA (Main)]] | ||
*** [[Hemorrhagic stroke]] | ***[[Hemorrhagic stroke]] | ||
*** [[Multiple sclerosis]] | ***[[Multiple sclerosis]] | ||
*** [[Amyotrophic Lateral Sclerosis (ALS)]] (UMN & LMN) | ***[[Amyotrophic Lateral Sclerosis (ALS)]] (UMN & LMN) | ||
**Spinal cord disease: | **Spinal cord disease: | ||
*** Infection ([[Epidural Abscess (Spinal)]]) | ***Infection ([[Epidural Abscess (Spinal)]]) | ||
*** Infarction/ischemia | ***Infarction/ischemia | ||
*** Trauma ([[Spinal Cord Syndromes]]) | ***Trauma ([[Spinal Cord Syndromes]]) | ||
*** Inflammation ([[Transverse Myelitis]]) | ***Inflammation ([[Transverse Myelitis]]) | ||
*** Tumor | ***Tumor | ||
**Peripheral nerve disease: | **Peripheral nerve disease: | ||
*** [[Guillain-Barre syndrome]] | ***Lyme disease | ||
*** Toxins ([[Ciguatera]]) | ***[[Guillain-Barre syndrome]] | ||
*** [[Tick paralysis]] | ***Toxins ([[Ciguatera]]) | ||
*** | ***[[Tick paralysis]] | ||
***[[Diabetes mellitus]] neuropathy (non-emergent) | |||
**NMJ disease: | **NMJ disease: | ||
*** [[Myasthenia gravis]] crisis | ***[[Myasthenia gravis]] crisis | ||
*** [[Botulism]] | ***[[Botulism]] | ||
*** [[Organophosphate toxicity]] | ***[[Organophosphate toxicity]] | ||
*** [[Lambert-Eaton myasthenic syndrome]] | ***[[Lambert-Eaton myasthenic syndrome]] | ||
**Muscle disease: | **Muscle disease: | ||
*** [[Rhabdomyolysis]] | ***[[Rhabdomyolysis]] | ||
*** [[Dermatomyositis]] | ***[[Dermatomyositis]] | ||
*** [[Polymyositis]] | ***[[Polymyositis]] | ||
*** Alcoholic myopathy | ***Alcoholic myopathy | ||
*'''Non-neuromuscular weakness''' | *'''Non-neuromuscular weakness''' | ||
**Can't miss diagnoses: | **Can't miss diagnoses: | ||
*** [[Sepsis (Main)]] | ***[[Sepsis (Main)]] | ||
*** [[Hypoglycemia]] | ***[[Hypoglycemia]] | ||
*** Periodic paralysis (electrolyte disturbance, K, Mg, Ca) | ***Periodic paralysis (electrolyte disturbance, K, Mg, Ca) | ||
****[[Hypokalemic periodic paralysis]] | ****[[Hypokalemic periodic paralysis]] | ||
****[[Thyrotoxic periodic paralysis]] | ****[[Thyrotoxic periodic paralysis]] | ||
*** Respiratory failure | ***Respiratory failure | ||
**Other | |||
***[[Cerebral palsy]] | |||
***[[Hypothermia]] | |||
***[[Parkinson's disease]] | |||
== | ==Evaluation== | ||
*Clinical diagnosis | |||
*Consider [[CVA]] or other neurologic workup | |||
==Management== | ==Management== | ||
*Treat underlying cause | |||
*Speech pathology | |||
==Disposition== | ==Disposition== | ||
*Depends on underlying cause | |||
==See Also== | ==See Also== | ||
==References== | ==References== | ||
<references/> | <references/> | ||
[[Category:Neurology]] | |||
[[Category:ENT]] | |||
[[Category:Symptoms]] | |||
Latest revision as of 02:11, 3 October 2019
Background
- Motor speech disorder characterized by poor articulation of language sounds or pronounciation[1]
- Cranial nerves involved include trigeminal nerve's motor branch (V), facial nerve (VII), glossopharyngeal nerve (IX), vagus nerve (X), and hypoglossal nerve (XII).
Clinical Features
- Includes abnormality to any of the following: breath control, duration of syllables, pitch, range, speed, steadiness, timing, tone, vocal quality, pitch, volume[2]
Differential Diagnosis
Stroke Types
Weakness
Neuromuscular weakness
- UMN:
- Spinal cord disease:
- Infection (Epidural Abscess (Spinal))
- Infarction/ischemia
- Trauma (Spinal Cord Syndromes)
- Inflammation (Transverse Myelitis)
- Tumor
- Peripheral nerve disease:
- Lyme disease
- Guillain-Barre syndrome
- Toxins (Ciguatera)
- Tick paralysis
- Diabetes mellitus neuropathy (non-emergent)
- NMJ disease:
- Muscle disease:
- Rhabdomyolysis
- Dermatomyositis
- Polymyositis
- Alcoholic myopathy
- Non-neuromuscular weakness
- Can't miss diagnoses:
- Sepsis (Main)
- Hypoglycemia
- Periodic paralysis (electrolyte disturbance, K, Mg, Ca)
- Respiratory failure
- Other
- Can't miss diagnoses:
Evaluation
- Clinical diagnosis
- Consider CVA or other neurologic workup
Management
- Treat underlying cause
- Speech pathology
Disposition
- Depends on underlying cause
See Also
References
- ↑ Duffy, J. Defining, Understanding, and Categorizing Motor Speech Disorders. In: Duffy, J. Motor Speech Disorders: Substrates, Differential Diagnosis, and Management. 3rd ed. . St. Louis, Mo: Elsevier Mosby; 2012 ISBN 0323024521.
- ↑ MacKenzie, C (2011). "Dysarthria in stroke: A narrative review of its description and the outcome of intervention". International Journal of Speech-Language Pathology 13 (2): 125–36. doi:10.3109/17549507.2011.524940. PMID 21480809