Spactic dysarthria 1/5

[Gazzzario]

@nessajack having said that, his answers are incredibly simplistic....

[nazzadabest]

Pseudobulbar palsy is an upper motor neurone lesion which involves CN IX, X and XII - resulting in increased reflexes (jaw jerk, gag reflex), spastic dysarthria, labile emotions, intelligence is not afffected. Thanks for the post. it was really helpful

[maryblueangel]

Thank you for posting this. I'm working on my Master's in Clinical Speech Pathology and I'm trying to get better at differentiating between the different dysarthrias!

[DrFuckingPepper]

It is so amazing to see the broad spectrum of function of the brain.

Thank you for uploading this.

[Naliana323]

well, he seems to have multiple subsystems that are effected so beginning with respiration you can do diaphragmatic breathing exercises and increase pitch to secrease strained voice quality. or try having him sigh before a sentence (breathy onset). You can try traditional atric treatment to improve intelligibility using placement cues, contrastive and referential stress tasks, drills to increase his speech rate; however spastic treatments dont have long term effects due to the tone in the muscle

[kayokogishitomi1]

what are some effective Speech therapy treatment approaches for Spastic Dysarthria? Note push/pull, and other effort closure techniques are counterintuitive to the spastic nature of the disorder. I have been allowing my patient to take multiple breaks throughout the therapy session as well as using an oral-facial massage to counteract the muscle spasticity; however, the efficacy behind this remains unclear. Any help?

[mamakatburner]

Thank you for posting this video! I think it can help me understand the difference between dysarthria and aphasia...I am confused, even though I have read many sources for a explanation, but still can't get it.

[Naliana323]

@mamakatburner Dysarthria is a motor speech disorder that affects coordination and articulation of speech sounds(ex.saying g for k). Aphasia affects the actual speech in terms of its content (language) you'll have difficulty recalling information that you once knew and can have a loss of meaning between the relationship of words and their meaning SO aphasia affects the content of language, dysarthria affects the preciseness of the speech sounds or it can affect ur voicing.  hope that helped.

[kayokogishitomi1]

@Naliana323 what are some effective Speech therapy treatment approaches for Spastic Dysarthria? Note push/pull, and other effort closure techniques are counterintuitive to the spastic nature of the disorder. I have been allowing my patient to take multiple breaks throughout the therapy session as well as using an oral-facial massage to counteract the muscle spasticity; however, the efficacy behind this remains unclear. Any help?

[xxlilsexyriaxx]

i though spastic dysarthria is damage to UPPER Motor Neurons- quoting my textbook right now..

[mamakatburner]

@xxlilsexyriaxx it is....I am looking at my book now, as well. But it is Bilateral instead of unilateral

[azmie90]

dysarthria-difficulty in coordination of the highly skilled organised movements involved in SPEECH,which becomes SLURRED AND DECOMPOSED .... *cerebellar ATAXIA one of the CEREBELLAR HEMISPHERE SYNDROME..

[tillAttack]

what a hero, God bless him. he is such a fighter...

[drjashan1]

Guys this is classic Cerebellar Dysarthria...very good internal medicine video...and No..this is not UMN lesion

[djdreamproductions]

@drjashan1 cerebellar lesions result in ataxic dysarthria; upper motor neuron lesions (bilateral) result in spastic dysarthria.

[wesam1987mu]

SPASTIC TOUNGE AND JERKY JAW

[NessieSakura]

it sounds like spastic dysarthria to me. He has either suffered a bilateral lacunar infarction or has amyotrophic lateral sclerosis. His voice doesn't seem to vary in loudness or pitch, so yeah it's probably pseuobulbar palsy

[medchode]

haha, people who make comments on youtube are inherently unintelligent.... oh wait, DAMN!

[kkambhampati]

Spastic Dysarthria due to Upper Motor Lesion involving Hypoglossal Nerve.

No Dysphasia. This is peripheral articulation problem as opposed to a speech problem per se. Certainly does not have receptive aphasia.

[mmoomm55]

pseudobulbar palsy

[amanlaura]

Este video es muy interesante, pero me gustaría una presentación en castellano para comprenderlo mejor ya que es de mucho interés para todas las personas que nos relacionamos con niños que pueden tener dificultades en la articulación del lenguaje.

[oswaljosc]

este paciente no tiene dificultad en la articulacion su problema es un daño a nivel del cerebelo.

[Pabloso100]

First of all I'd like to thank you for sharing with us this valuable material. According to the picture, I think the patient has motor aphasia (Broca's area). Because he is able to understand speech and questions, but struggles with answering. His speech is very slow and is not clear.

[girabbit85]

I agree with your observations, but his speech is not agrammatic (e.g. "down the street on his bicycle"), so it is unlikely to be Broca's aphasia.

His speech is slow and effortful because of hypertonicity, which is the key feature of spasticity.

[xxegonomicxx]

I came to post this. Telegraphic speech is not present (typical of Broca's aphasia), and his strained-strangled voice, slow rate, and lack of variability in pitch and loudness are salient features of spastic dysarthria. His right hand also appears to have some abnormal muscular movements. Good eye and ear, girabbit85.

[ApalmerHels]

This is a problem with the cerebellum, the part of the brain that controls voluntary body movements. He doesn't need directed, his cognitive functions are perfect, he just can't control his muscles well...It's a terrible degenerative disease.

[Paesly]

This absolutely does not appear to be a problem with the cerebellum which would result in incoordination and drunken like speech. Plus, to say it controls voluntary body mvmts is a very elementary description of its multitude of functions. He does appear to have spastic dysarthria which is localized in bilateral UMN. His speech characteristics are indicative of increased effort to speak, strained/strangled voice, very obvious pitch breaks, and harsh voice.

[Avionicgenius]

Can you explain this to me? Since i take it you're involved with medicine. I've observed that he has to be told to give more information in his answer. He isn't stupid, he just has to be directed. This is why i wonder if this is more than just speech problem. Please enlighten me

[Yemenjapan]

it is not necessary that he is stupid ..he is just having laceration to the nerve controlling the tongue muscle ..for example the CN XII which innervate the posterior third of the tongue or laceration to the CN IX -maybe due to jugular foramen syndrome ix-x-xi , xii ...

[Yemenjapan]

it is not necessary that he is stupid ..he is just having laceration to the nerve controlling the tongue muscle ..for example the CN XII which innervate the posterior third of the tongue or laceration to the CN IX -maybe due to jugular foramen syndrome ix-x-xi , xii ...

[Paesly]

First, CN XII inntervates all muscles of the tongue (except genioglossus). Maybe you were thinking IX which is sensory for the post 1/3 of the tongue. Second, if it was a problem with a cranial nerve, he would have flaccid dysarthria characterized by weakness, perhaps eventual fasciculations in the tongue, and poor articulation. This is not the case here.

[Paesly]

Scratch that, XII innervates all muscles of the tongue except geniohyoid.

[Yemenjapan]

i do not really understand what did you mean by flaccid dysarthria ..so i think there is no mental impairment ..do you agree ?

[Paesly]

flaccid dysarthria is caused by damage to the lower motor neuron or cranial nerve. too much to explain here, you should read about it if you're interested. i don't believe this person has a mental impairment. they appear to have a motor speech disorder.

[yootubesuxarse]

very useful

[bubloojee]

excellent.thanku. pls add more.