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Query: UMLS:C0013362 (dysarthria)
 3,768 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Amyotrophic lateral sclerosis (ALS) is a degenerative neurologic disease having both upper and lower motor neuron signs and symptoms. When the speech musculature is involved, a mixed dysarthria and dysphagia usually result. In a 49-year-old man with ALS, dysarthria and dysphagia progressed from mild to severe forms over 17 months. Eleven months after the patient first experienced symptoms, neurologic examination showed fasciculations of the extremities and tongue, limb weakness, and hyperreflexia of the limbs and velopharyngeal mechanism. Tongue strength was one-fourth that of normal. Lingual alternate motions rates for consonant-vowel syllables were also reduced. To enhance lingual strength and swallowing, a tongue-strengthening program was developed for use with articulation training; to augment velopharyngeal function, a palatal lift was fitted; and to increase extremity strength, physical therapy was initiated. Six months after the initial neurologic examination, medical and speech reevaluation showed progressive weakness of the body parts affected initially; continued decline in tongue strength and lingual alternate motion rate; hypoactive reflex activity, indicative of progressive involvement of the lower motor neuron system; and continued deterioration of articulation and phonation owing to the progressive nature of the disease.
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PMID:Progressive speech deterioration and dysphagia in amyotrophic lateral sclerosis: case report. 49 10

By means of pellet tracking techniques using an X-ray microbeam system, observations of the articulatory movements of various types of dysarthric subjects were conducted. In selected cases, electromyography (EMG) was also performed. The data were specifically examined for range, velocity, and consistency (reproducibility) of the movements of the articulators, as well as the pattern of coordination of the different articulators involved. It was found in the case of ataxic dysarthria of cerebellar origin, for example, that the dynamic patterns were best represented as a difficulty in the initiation of purposeful movements and an inconsistency of articulatory movements, particularly in the repetitive production of a monosyllable. On EMG, breakdown of the rhythmical patterns in the articulatory muscles was quite obvious in the repetition of a monosyllable. In the case of amyotrophic lateral sclerosis (ALS), decrease in the range and velocity of movements was noted. This resulted from reduced neuromuscular units (NMU) activities manifested in clinical EMG. Analysis of the dynamic aspects of the dysarthrias is a promising approach for elucidating the nature of central problems of speech production and for a differential diagnosis of various types of dysarthrias.
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PMID:Analysis of abnormal articulatory dynamics in two dysarthric patients. 63 76

The purpose of this study was to describe the formant trajectories produced by males with amyotrophic lateral sclerosis (ALS), a degenerative neuromuscular disease that is typically associated with dysarthria. Formant trajectories of 25 males with ALS and 15 neurologically normal geriatric males were compared for 12 words selected from the speech intelligibility task developed by Kent et al. [J. Speech. Hear. Disord. 54, 482-499 (1989)]. The results indicated that speakers with ALS (1) produced formant transitions having shallower slopes than transitions of normal speakers, (2) tended to produce exaggerations of formant trajectories at the onset of vocalic nuclei, and (3) had greater interspeaker variability of formant transition characteristics than normal speakers. Within the group of ALS speakers, those subjects who were less than 70% intelligible produced distinctly more aberrant trajectory characteristics than subjects who were more than 70% intelligible. ALS subjects who were less than 70% intelligible produced many trajectories that were essentially flat, or that had very shallow slopes. These results are discussed in terms of the speech production deficit in the dysarthria associated with ALS, and with respect to the potential influence of aberrant trajectories on speech intelligibility.
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PMID:Formant trajectory characteristics of males with amyotrophic lateral sclerosis. 155 10

This is the first large scale case series of motor neurone disease (MND) in Thailand. Seventy-seven patients were identified between 1978 and 1984 at Siriraj Hospital Medical School, Bangkok, Thailand. Fifty-five patients were male (71.43%) and the mean age of the patients was 51.55 (SD 14.26) years with the range of 17 to 78 years. Clinical classification of MND was categorized as progressive bulbar palsy (PBP), 26 patients (33.77%); amyotrophic lateral sclerosis (ALS), 42 patients (54.54%); and progressive spinal atrophy (PSA), 9 patients (11.69%). The mean age of PBP, ALS and PSA were in the order of 57.61 (SD 12.09), 52.81 (SD 11.18), and 28.11 (SD 9.44) years. Progressive spinal atrophy group was younger than PBP and ALS groups significantly at the P-value less than 0.05 by analysis of variance and Duncan tests. Fifty-three patients (72.60%) were resident in Bangkok and the central part of Thailand. The main presenting symptoms were wasting of the small muscles of both hands, leg weakness, and speech and/or swallowing difficulties. These symptoms were found in 62 patients (81.58%). Nearly half of the patients (48.68%) came to our care within six months of onset, 22.8 per cent presented with asymmetry of motor wasting, while limb and trunk fasciculation was seen in 73.61 per cent. Dysarthria, dysphagia and tongue fasciculation were recorded as 51.32, 48.68, 60.53 per cent respectively. Exaggerated deep tendon reflexes were noted as 65.79 and 80.26 per cent over the upper and lower limbs, while Babinski sign was elicited in only 23.3 per cent of the patients.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Motor neurone disease in Thailand: the clinical aspects of 77 patients. 194 Jul 1

In myasthenia gravis and amyotrophic lateral sclerosis the ENT specialist or the phoniatrician may be consulted first, because in about 30 percent of all cases the initial symptoms are dysarthria, dysphagia or dyspnea. Three typical cases of each condition are presented. The quality of life of the patients can be improved considerably by early diagnosis and treatment. Special diagnostic and therapeutic procedures are described.
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PMID:[Dysarthria, dysphagia or dyspnea as a reason for the initial consultation in pseudoparalytic myasthenia gravis and amyotrophic lateral sclerosis]. 231 Apr 61

We report the case of a 62-year old man presenting with generalized muscular weakness, amyotrophy, dysarthria and dysphagia. Neurological examination showed bilateral pyramidal signs and lingual fasciculations. The clinical diagnosis was amyotrophic lateral sclerosis, since only shivers and weight loss pointed to hyperthyroidism. However, after several months the patient developed typical manifestations of hyperthyroidism. After treatment of hyperthyroidism, the neurological symptoms disappeared. Although this association is extremely rare, one must have in mind the possibility of thyroid dysfunction when studying patients with amyotrophic lateral sclerosis.
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PMID:[Amyotrophic lateral sclerosis syndrome and hyperthyroidism. Cure with antithyroid drugs]. 233 Apr 66

Patients with amyotrophic lateral sclerosis (ALS), a progressive neurodegenerative disorder, commonly develop bulbar symptoms including dysphagia, dysarthria, and defective airway protection. Otolaryngologists/head and neck surgeons are frequently asked to assist in the management of these problems. We reviewed our experience of 13 surgical procedures in 7 patients with advanced bulbar ALS. In spite of technically good surgery, 3 patients died within 1 week of hospitalization. Four patients appeared to benefit from the surgery. Patients with bulbar ALS are a high risk group because of chronic malnutrition and dehydration, covert aspiration and pneumonitis, and diminished ventilation. A team approach to these problems is stressed. Perioperative morbidity can be reduced with careful preoperative preparation and patient selection.
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PMID:Palliative surgery in patients with bulbar amyotrophic lateral sclerosis. 247 67

A 64-year-old male patient of amyotrophic lateral sclerosis (ALS) with frozen gait, axial rigidity and supranuclear upper gaze palsy was reported. We have followed this patient more than four years. He was well until November 1982, when he noticed weakness of left arm. In March 1983, he noticed hypogeusia and in July, he developed dysarthria and frozen gait. On admission, he was alert and oriented. Neurological examination revealed dysarthria, dysphagia and muscular weakness and atrophy in bilateral upper extremities, dominantly in left side. He showed remarkable frozen gait, retropulsion and could not walk. Brain CT showed mild dilatation of the third ventricle. In August 1988, he showed tongue atrophy, and weakness and atrophy of the extremities progressed during these four years. He also showed axial rigidity and frozen gait. Brain CT showed severe third ventricular dilatation and atrophy of tegmentum of the midbrain and cerebellum that were compatible with progressive supranuclear palsy (PSP). Six months later, he developed upper gaze palsy. From these findings, we concluded that this patient had a quite unique clinical features of both ALS and PSP.
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PMID:[A case of amyotrophic lateral sclerosis associated with clinical features of progressive supranuclear palsy]. 259 46

The measurement of intelligibility in dysarthric individuals is a major concern in clinical assessment and management and in research on dysarthria. The measurement objective is complicated by the fact that intelligibility is not an absolute quantity but rather a relative quantity that depends on variables such as test material, personnel, training, test procedures, and state of the speaker. This paper reviews scaling procedures and item identification tests as they have been applied to dysarthric speech. Based in part on previous studies of speech of the hearing impaired, a profile has been designed to direct research on the acoustic or physiologic correlates of dysarthric intelligibility impairment. In addition, a word intelligibility test is proposed for use with dysarthric speakers. This test is designed to examine 19 acoustic-phonetic contrasts that are likely to (a) be sensitive to dysarthric impairment and (b) contribute significantly to speech intelligibility. Preliminary data from a sample of subjects with amyotrophic lateral sclerosis are presented to illustrate the use of this test in the phonetic interpretation of intelligibility impairment.
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PMID:Toward phonetic intelligibility testing in dysarthria. 281 29

Patients with bulbar amyotrophic lateral sclerosis (ALS) are often referred to the otolaryngologist/head and neck surgeon and speech pathologist for evaluation and management of dysphagia and dysarthria. These patients comprise an unusual group because of the progressive and multi-system nature of their illness. The neuromuscular disabilities associated with bulbar ALS cause a myriad of related symptoms associated with swallowing, speech, and respiration. Although the rate of progression cannot be predicted, a general pattern of progression is noted. Bulbar disease accounts for the majority of the worst symptoms of ALS. The loss of the ability to swallow changes eating from a pleasurable task to a burden of survival. Loss of communication effectively imprisons the patient in a state of isolation. The progressive weakness of respiration, predominantly a spinal rather than bulbar manifestation, is the cause of death for nearly all ALS patients and is also discussed. The general patterns of progression of bulbar ALS are outlined in this paper. The development of symptoms are correlated with specific treatment recommendations to aid the clinician in devising an orderly plan of management for this progressive disease.
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PMID:Bulbar amyotrophic lateral sclerosis: patterns of progression and clinical management. 258 13


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