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Dysarthria
Impairment of speech; Slurred speech; Speech disorders - dysarthria
Dysarthria is a condition in which you have difficulty saying words because of problems with the muscles that help you talk.
Causes
In a person with dysarthria, a nerve, brain, or muscle disorder makes it difficult to use or control the muscles of the mouth, tongue, larynx, or vocal cords.
The muscles may be weak or completely paralyzed. Or, it may be hard for the muscles to work together.
Dysarthria may be the result of brain damage due to:
- Brain injury
-
Brain tumor
Brain tumor
A primary brain tumor is a group (mass) of abnormal cells that start in the brain.
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Dementia
Dementia
Dementia is a loss of brain function that occurs with certain diseases. It affects memory, thinking, language, judgment, and behavior.
Read Article Now Book Mark Article - Disease that causes the brain to lose its function (degenerative brain disease)
-
Multiple sclerosis
Multiple sclerosis
Multiple sclerosis is an autoimmune disease that affects the brain and spinal cord (central nervous system).
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Parkinson disease
Parkinson disease
Parkinson disease causes certain brain cells to die. These are the cells that help control movement and coordination. The disease leads to shaking ...
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Stroke
Stroke
A stroke occurs when blood flow to a part of the brain stops. A stroke is sometimes called a "brain attack. " If blood flow is cut off for longer th...
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Dysarthria may result from damage to the nerves that supply the muscles that help you talk, or to the muscles themselves from:
- Face or neck trauma
-
Surgery for head and neck cancer, such as partial or total removal of the tongue or
voice box
Voice box
Laryngectomy is surgery to remove all or part of the larynx (voice box) in your throat.
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Dysarthria may be caused by diseases that affect nerves and muscles (neuromuscular diseases):
-
Cerebral palsy
Cerebral palsy
Cerebral palsy is a group of disorders that can involve brain and nervous system functions, such as movement, learning, hearing, seeing, and thinking...
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Muscular dystrophy
Muscular dystrophy
Muscular dystrophy is a group of inherited disorders that cause muscle weakness and loss of muscle tissue, which get worse over time.
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Myasthenia gravis
Myasthenia gravis
Myasthenia gravis is a neuromuscular disorder. Neuromuscular disorders involve the muscles and the nerves that control them.
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Amyotrophic lateral sclerosis (
ALS
)
ALS
Amyotrophic lateral sclerosis, or ALS, is a disease of the nerve cells in the brain, brain stem and spinal cord that control voluntary muscle movemen...
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Other causes may include:
- Alcohol intoxication
- Poorly fitting dentures
- Side effects of medicines that act on the central nervous system, such as narcotics, phenytoin, or carbamazepine
Symptoms
Depending on its cause, dysarthria may develop slowly or occur suddenly.
People with dysarthria have trouble making certain sounds or words.
Their speech is poorly pronounced (such as slurring), and the rhythm or speed of their speech changes. Other symptoms include:
- Sounding as though they are mumbling
- Speaking softly or in a whisper
- Speaking in a nasal or stuffy, hoarse, strained, or breathy voice
A person with dysarthria may also drool and have problems chewing or swallowing. It may be hard to move the lips, tongue, or jaw.
Exams and Tests
The health care provider will take a medical history and perform a physical exam. Family and friends may need to help with the medical history.
A procedure called laryngoscopy may be done. During this procedure, a flexible viewing scope is placed in the mouth and throat to view the voice box.
Laryngoscopy
Laryngoscopy is an exam of the voice box (larynx). It can be done using a small mirror held just below the back of your palate, or a rigid or flexib...
Tests that may be done if the cause of the dysarthria is unknown include:
- Blood tests for toxins or vitamin levels
-
Imaging tests, such as an
MRI
or
CT scan
of the brain or neck
MRI
A magnetic resonance imaging (MRI) scan is an imaging test that uses powerful magnets and radio waves to create pictures of the body. It does not us...
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A computed tomography (CT) scan is an imaging method that uses x-rays to create pictures of cross-sections of the body. Related tests include:Abdomin...
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Nerve conduction studies and
electromyogram
to check the electrical function of the nerves or muscles
Electromyogram
Electromyography (EMG) is a test that checks the health of the muscles and the nerves that control the muscles.
Read Article Now Book Mark Article - Swallowing study, which may include x-rays and drinking a special liquid
Treatment
You may need to be referred to a speech and language therapist for testing and treatment. Special skills you may learn include:
- Safe chewing or swallowing techniques, if needed
- To avoid conversations when you are tired
- To repeat sounds over and over again so you can learn mouth movements
- To speak slowly, use a louder voice, and pause to make sure other people understand
- What to do when you feel frustrated while speaking
You can use many different devices or techniques to help with speech, such as:
- Apps that use photos or speech
- Computers or cell phones to type out words
- Flip cards with words or symbols
Surgery may help people with dysarthria.
Things that family and friends can do to communicate better with someone who has dysarthria include:
Communicate better
Speech and language disorder - dysarthria care; Slurred speech - dysarthria; Articulation disorder - dysarthria
- Turn off the radio or TV.
- Move to a quieter room if needed.
- Make sure lighting in the room is good.
- Sit close enough so that you and the person who has dysarthria can use visual cues.
- Make eye contact with each other.
Listen carefully and allow the person to finish. Be patient. Make eye contact with them before speaking. Give positive feedback for their effort.
Outlook (Prognosis)
Depending on the cause of dysarthria, symptoms may improve, stay the same, or get worse slowly or quickly.
- People with ALS eventually lose the ability to speak.
- Some people with Parkinson disease or multiple sclerosis lose the ability to speak.
- Dysarthria caused by medicines or poorly fitting dentures can be reversed.
- Dysarthria caused by a stroke or brain injury will not get worse, and may improve.
- Dysarthria after surgery to the tongue or voice box should not get worse, and may improve with therapy.
When to Contact a Medical Professional
Call your provider if you have:
- Chest pain, chills, fever, shortness of breath, or other symptoms of pneumonia
- Coughing or choking
- Difficulty speaking to or communicating with other people
- Feelings of sadness or depression
References
Halpern H, Goldfarb R. Dysarthria. In: Halpern H, Goldfarb R, eds. Language and Motor Speech Disorders in Adults . 3rd ed. Burlington, MA: Jones and Bartlett Learning; 2013:chap 8.
Kirshner HS. Dysarthria and apraxia of speech. In: Daroff RB, Jankovic J, Mazziotta JC, Pomeroy SL, eds. Bradley's Neurology in Clinical Practice . 7th ed. Philadelphia, PA: Elsevier; 2016:chap 14.
Review Date: 7/4/2016
Reviewed By: Amit M. Shelat, DO, FACP, Attending Neurologist and Assistant Professor of Clinical Neurology, SUNY Stony Brook, School of Medicine, Stony Brook, NY. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Isla Ogilvie, PhD, and the A.D.A.M. Editorial team.
