University:
Johns Hopkins University
Course:
ME.250 | Medicine
Academic year:

2023
Views:

397

Pages:

1
Author:

esfredint7qo

Neurological System Affected: ATAXIC DYSARTHRIA cerebellum/cerebellar control circuit Common Pt Complaints sound as if they are drunk, feel as if they are stumbling over words, bite tongue or cheek when eating, speech deteriorates significantly with alcohol intake Associated neurological symptoms broad based stance and gait, instability of trunk Cerebellar deficits results in uncoordinated movements; disrupts timing force, range, and direction of movements (no problem with muscle strength/tone) degenerative (Frederick’s ataxia), vascular disorders (aneurysm, arteriovenous malformations, hemorrhage in cerebellum), tumor in cerebellum, toxic/metabolic conditions (chronic alcohol abuse, severe malnutrition, neurotoxic effects of drugs like Dilantin, lithium, and valium), hypothyroidism POSSIBLE TREATMENT Speaking at beginning of exhalation, hand on abdomen for cue Stop Phonation Early- Teach pt to terminate earlier in expiratory cycle If stumbles over voice/voiceless transitions- Continuous phonation can be taught Possible Medical Dx POSSIBLE SPEECH SYSTEM DEFICIT Respiration- may speak on low air b/c of coordination difficulties Phonation- may be normal or harsh, may demonstrate continuous voicing Resonance- normal Articulation- imprecise consonants, vowel distortions, irregular articulatory breakdowns, may have more breakdowns on multisyllabic words prolonged phonemes Prosody- excess and equal stress, phoneme and pause prolongations, bursts of intensity after pauses, slow rate Intelligibility drills, exaggerating consonants/overarticulation, minimal contrast drills, Integral stimulation – say at same time as SLP, then follow direct model, then independently May need to further reduce rate for articulatory precision – talk with metronome, with model, hand tapping, cued reading material with pauses marked. Pitch range exercises/intonation profiles. Contrastive stress drills. Chunking into syntactic units Note: Pharmacologic treatment for cerebellar ataxia has not been successful in general. Diamox may be effective in treating episodic ataxia. In general, the focus of management activities is behavioral with the focus on improving or compensating for problems related to motor control/coordination. Most focus is on modifying rate and prosody to improve intelligibility and when possible, further modifying rate and prosody to improve naturalness