Dysarthria

What is dysarthria?

Dysarthria is a motor speech disorder, meaning your muscles controlling speech are weak or difficult to control. If you have dysarthria, you would have difficulty speaking, due to brain damage or brain changes later in life. People with dysarthria may be difficult to understand when they speak. They might only be able to communicate in short words or phrases, or even be completely unintelligible. 

Dysarthria does not affect your cognitive functions at all, but these might be affected by any underlying condition that is possibly causing your dysarthria.

How will having dysarthria affect me?

Dysarthria can greatly affect your ability to function on a day-to-day basis, because it makes it difficult to express yourself, which is important in expressing your personality and forming bonds with others. This affects your social interactions and relationships, work and school. It can also affect how people view you every day. 

So, although dysarthria does not cause any serious or long-term health issues, it can be really hard to cope with every day and could cause major emotional distress if not managed properly.

What does having dysarthria feel like?

People with dysarthria can experience the following symptoms:

  • Slurred, slow speech
  • Nasal sounding or breathy speech
  • Inability to control speech volume
  • Strained, hoarse voice
  • Monotone speech
  • Difficulty moving tongue and facial muscles
  • Difficulty swallowing (also known as dysphagia)

If you have dysarthria, the muscles in your face, lips, tongue, throat and upper respiratory tract can be affected. 

What are the causes of dysarthria?

The muscles which control your ability to speak are controlled by the brain and your nervous system. Dysarthria can develop if they are damaged, and this condition can be developmental or acquired.

Developmental dysarthria can develop as a result of trauma or damage to the brain before birth or during birth, e.g. if a child has cerebral palsy. This kind of dysarthria is usually found in children.

Acquired dysarthria develops as a result of brain changes later in life, such as trauma or damage caused by a stroke, head injury or brain tumour. This kind of dysarthria can also develop from a progressive or neurodegenerative condition that damages the brain or nervous system. It is a frequent symptom of many neurological conditions, including:

  • Amyotrophic lateral sclerosis (ALS)
  • Guillain-Barre syndrome
  • Lyme disease
  • Multiple sclerosis
  • Muscular dystrophy
  • Parkinson’s disease
  • Wilson’s disease
  • Intracranial hypertension
  • Stroke

Inflammatory conditions such as autoimmune diseases can cause dysarthria. Some sedatives and certain drugs, as well as exposure to toxic chemicals and substances (e.g. carbon monoxide) can also cause dysarthria. This kind of dysarthria is more likely to be found in adults.

Dysarthria can further be split into spastic dysarthria, flaccid dysarthria, ataxic dysarthria and hypokinetic dysarthria, and these classifications are based on the symptoms you experience and which part of the brain is damaged. Talk to your doctor about this to find out more.

How is dysarthria diagnosed?

If you have symptoms of dysarthria, your doctor might refer you to a speech-language pathologist to run some tests and determine exactly what kind of dysarthria you have. You might also be referred to a neurologist who can help you to identify the underlying cause of the condition.

Imaging. CT and MRI imaging scans can be done to examine the large veins that carry the blood from the brain, and create X-ray images of your head and brain and check for any abnormalities. This can help to identify the cause of dysarthria.

Electroencephalogram (EEG). Your doctor may perform an EEG to measure the electrical activity happening in your brain.

Electromyogram (EMG). In some cases, your doctor may conduct an EMG, which measures the electrical activity of your nerves and muscles. There are two parts to an EMG. 

The first part comprises of nerve conduction studies (NCS), which measures the rate at which electrical impulses move through your nerves. During this test, small patches which deliver electrical pulses will be attached to your skin. This process may cause you some discomfort depending on the strength of the electrical pulse but is generally painless. 

The second part is known as a needle electrode examination, which measures the electrical activities in your muscles. During this test, five or more thin needles will be inserted into your muscle. You may experience a slight pain during the insertion of the needles. However, this test is otherwise painless as well.

Lumbar puncture (LP). Your doctor may also perform an LP, also known as a spinal tap, in order to withdraw a sample of your cerebrospinal fluid for testing. This can help to show if you have a serious infection or disorder of your central nervous system.

Neuropsychological tests.  Lastly, your doctor may conduct several tests to measure and evaluate your cognitive skills, ability to understand speech, amongst other skills.

How can I manage my dysarthria?

If you currently have dysarthria, do not be disheartened as there are ways to manage it, namely speech and language therapy. Speech and language therapy aims to help restore as much as your speech as possible, increase your ability to communicate with others, and search for alternative ways to communicate with others. Your doctor will likely refer you to a speech and language therapist to do so. 

Through therapy, you can use the speech already available to you more effectively, and also try to increase the range and consistency of sound production, and help you communicate effectively.

With speech therapy, as well as support from your family, friends and doctors, improvement of your condition is entirely possible.

If you think that you may be experiencing dysarthria, visit a doctor and seek medical attention immediately.

References
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  1. Dysarthria: Types, causes, and treatment. (2019, December 20). Medical News Today. https://www.medicalnewstoday.com/articles/327362#summary
  2. Enderby, P. (2013, January 1). Chapter 22 – Disorders of communication: dysarthria (M. P. Barnes & D. C. Good, Eds.). ScienceDirect; Elsevier. https://www.sciencedirect.com/science/article/pii/B9780444529015000228
  3. Hartelius, L., Elmberg, M., Holm, R., Lövberg, A.-S., & Nikolaidis, S. (2007). Living with Dysarthria: Evaluation of a Self-Report Questionnaire. Folia Phoniatrica et Logopaedica, 60(1), 11–19. https://doi.org/10.1159/000111799
  4. NHS Choices. (2020). Dysarthria (difficulty speaking). NHS. https://www.nhs.uk/conditions/dysarthria/
  5. 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), 125–136. https://doi.org/10.3109/17549507.2011.524940