Abnormal Speech

Abnormal Speech

·        Types:

o  Dysphonia/dysarthria: problems with the mechanics, not ideas, of speech production (eg nerves involved in motor control, connective tissue disease, etc). Say „baby hippopotamus‟

o  Broca‟s (expressive) dysphagia: Non-fluent speech with malformed words. Reading and writing are impaired but comprehension intact. Patients understand questions. Inferio-lateral frontal lesion

o  Wernicke‟s (receptive) dysphasia: Empty fluent speech.  Maybe mistaken for psychotic speech.

o   Reading writing and comprehension are impaired.  Posterior Superior temporal lobe lesion.

o  Cerebellar disease: ataxia of the muscles of speech ® slurred and irregular speech

o  Pseudo-bulbar palsy: UMN. Exaggerated jaw jerk, difficultly swallowing, maybe emotional liability. Due to upper motor neuron lesion above the mid pons due to bilateral CV disease, severe MS or motor neuron disease

o  Bulbar palsy: LMN eg facial nerve, Guillian Barre, etc

·        Assessment:

o  If speech fluent, grammatical and meaningful or patient can repeat a sentence Þ dysphagia unlikely

o  If the patient can comprehend simple instructions with several steps Þ Wernicke‟s unlikely