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DYSARTHRIA AND SPEECH DISORDERS ( D.S.D.)
Besides dysarthria, three other types of speech disorders should be considered here: dysphasia, cerebella speech, and extra pyramidal speech. In each case, the anatomic location in the nervous system is fairly specific. 
DYSARTHRIA AND SPEECH DISORDERS DysarthriaThis may be due to a lesion at the end organ (muscles of the mouth and tongue), the myoneural junction, the peripheral branches of the fifth (trigeminal) and twelfth (hypoglossal) cranial nerves, the brainstem, or the cerebrum. 1. End organ. Hypertrophy of the tongue from myxedema, carcinoma of the tongue, and painful lesions of the mouth and tongue may cause speech difficulty. Inability to swallow may leave saliva and food in the mouth and interfere with speech. The facioscapulohumeral form of muscular dystrophy may cause dysarthria. 2. Myoneural junction. Myasthenia gravis, a treatable form of dysarthria, should always be ruled out. 3. Peripheral nerve. Hypoglossal nerve damage from trauma and severing of the motor portion of the trigeminal nerve in trauma and surgery are the principal lesions here. 4. Brainstem. Poliomyelitis, Guillain–Barré syndrome, disseminated encephalomyelitis, brainstem gliomas, and basilar artery occlusions are the most important lesions to recall in this category. 5. Cerebrum. Any disorder that may cause hemiplegia from cerebral involvement may cause dysarthria and pseudo bulbar palsy. Cerebral thrombi, emboli, or hemorrhages are perhaps the most significant of these. Frontal lobe tumors or abscesses may be the cause here. Diffuse |