Flaccid Dysarthria Essay

2038 words - 9 pages

Flaccid dysarthria results from damage to the lower motor neurons (LMN) or the peripheral nervous system (Hageman, 1997). The characteristics of flaccid dysarthria generally reflect damage to cranial nerves with motor speech functions (e.g., cranial nerves IX, X, XI and XII) (Seikel, King & Drumright, 2010). Lower motor neurons connect the central nervous system to the muscle fibers; from the brainstem to the cranial nerves with motor function, or from the anterior horns of grey matter to the spinal nerves (Murdoch, 1998). If there are lesions to spinal nerves and the cranial nerves with motor speech functions, it is indicative of a lower motor neuron lesion and flaccid dysarthria. Damage to lower motor neurons that supply the speech muscles is also known as bulbar palsy (Pena-Brooks & Hedge, 2007). Potential etiologies of flaccid dysarthria include spinal cord injury, cerebrovascular accidents, tumors or traumatic brain injury (Pena-Brooks & Hedge, 2007). Possible congenital etiologies of flaccid dysarthria include Moebius syndrome and cerebral palsy. Flaccid dysarthria can also arise from infections such as polio, herpes zoster, and secondary infections to AIDS (Pena-Brooks & Hedge, 2007). Additionally, demyelinating diseases such as Guilian-Barre syndrome and myotonic muscular dystrophy can also lead to flaccid dysarthria (Pena-Brookes & Hedge, 2007). The lower motor neuron lesion results in loss of voluntary muscle control, and an inability to maintain muscle tone. Fasciculations, or twitching movements, may occur if the cell body is involved in the lesion (Seikel et. al., 2010). The primary speech characteristics of flaccid dysarthria include imprecise consonant production, hypernasal resonance, breathiness, and harsh voice (Hageman, 1997) Additionally, an individual with flaccid dysarthria may have a monotone pitch, shorter stretches of speech, and a decreased volume. Acoustically, flaccid dysarthria results in excessive shimmer and jitter, as well as a reduced noise to harmonic ratio (Hageman, 1997). Furthermore, respiration is affected due to reduced vital capacity (Murdoch, 1998).
Lower motor neuron damage can result in respiratory weakness, inability to coordinate respiration for speech, and insufficient ventilation (Hageman, 1997). Poor breath support is a characteristic of flaccid dysarthria that negatively impacts intelligibility. According to Brown et. al. (as cited in Johansson, Nygren-Bonnier & Schalling, 2011), targeting respiratory support can improve characteristics of flaccid dysarthria such as short phrases, loudness, phonatory disturbances, impaired prosody and imprecise comments. Thus, respiratory treatment for flaccid dysarthria can be implemented using glossopharyngeal breathing. Originally, glossopharyngeal breathing was designed for post-polio patients to increase alveolar ventilation (Dail, 1951). Similar to post-polio patients, glossopharyngeal breathing can be used to optimize the speech and voice of a person with...

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