Dysarthria

Dysarthria is a condition associated with the weakening of the muscles that control speech. People with this condition usually have slurred or slow speech which can be difficult to understand.

Dysarthria can be caused by neurological disorders, such as stroke, brain injury or tumors. Conditions that cause facial paralysis or tongue or throat muscle weakness can also lead to dysarthria.

Certain medications have also been shown to cause this condition. Speech can be improved by treating the underlying condition.

Speech therapy can also be beneficial for patients with dysarthria as it also helps to improve speech.

The signs and symptoms of dysarthria are different for different patients, depending on the cause. This also depends on the type of dysarthria that a patient has.

Some of the signs and symptoms include:

• Slurred or slow speech
• Inability to speak louder than a whisper or speaking too loudly
• Rapid speech which is hard to understand
• Nasal, raspy or strained voice
• Uneven or abnormal speech rhythm
• Uneven speech volume
• Monotone speech
• Difficulty moving the tongue or facial muscles

Conditions that can cause dysarthria include:

• Amyotrophic lateral sclerosis (ALS or Lou Gehrig's disease)
• Head or brain injury
• Brain tumor
• Cerebral palsy
• Guillain-Barre syndrome
• Huntington's disease
• Lyme disease
• Multiple sclerosis
• Muscular dystrophy
• Myasthenia gravis
• Parkinson's disease
• Stroke
• Wilson's disease

People with dysarthria may have a hard time moving the muscles of the mouth, face or upper part of the respiratory system that control speech.

A speech-language specialist usually examines a patient to diagnose the type of dysarthria that he/she has.

This information can help the neurologist to determine the cause of dysarthria. Doctors may also perform a physical exam.

Other tests used in the diagnosis of dysarthria include:

• Imaging tests, such as MRI or CT scan to create detailed images of the brain, head or neck that may be helpful in determining the cause of dysarthria.
• Electroencephalogram to measure the electrical activity of the brain, electromyogram to measure the electrical activity in the nerves as they transmit impulses to the muscles and nerve conduction studies that measure the strength and speed of impulses as they travel from the nerves to the muscles. These tests can be used to pinpoint the source of the symptoms that a patient has.
• Blood and urine test to determine if dysarthria is as a result of an infection or inflammatory disease.
• Lumbar puncture (spinal tap), a procedure in which a needle is inserted into the lower part of the back to remove a small sample of cerebrospinal fluid for lab analysis. This test is important as it can help to diagnose serious infections, disorders of the central nervous system and, cancers of the brain or spinal cord.
• Brain biopsy for lab examination.
• Neuropsychological tests which measure a patient's thinking (cognitive) skills, ability to understand speech, ability to write and other skills. Although dysarthria does not affect cognitive skills, the underlying cause can.

The treatment of dysarthria depends on the type of speech problem and on the underlying cause. If medications are the cause of the dysarthria, changing or discontinuing such medications can help to improve speech.

Speech and language therapy may also be recommended for improving speech. Speech goals may include adjusting speech rate, strengthening muscles, increasing breath support, improving articulation and improving communication with family and friends.

If speech and language therapy are not effective, a speech-language pathologist may recommend other communication methods, such as augmentative and alternative communication systems.

These communication methods can include visual clues, gestures, an alphabet board or computer-based technology.

There are different ways to adapt your lifestyle in coping with dysarthria.

The following can help patients with dysarthria to communicate more effectively:

• Speaking slowly
• Introducing a topic with one word or short phrase before speaking in longer sentences
• Gauge understanding - asking listeners to confirm that they know what a person with dysarthria is saying
• Keeping speech short
• Having back-ups, such as writing messages on a cellphone or hand-held device or carrying a pencil and paper around
• Using shortcuts, such as drawings, diagrams or photos during conversations.

There are several complications associated with dysarthria.

Dysarthria may lead to communication problems. This can affect relationships with family and friends and also make social situations challenging.

Some people with dysarthria may become socially isolated and depressed.