Dysarthria

In a person with dysarthriaa nervebrainor muscle disorder makes it difficult to use or control the muscles of the mouthtonguelarynxor vocal cords.

The muscles may be weak or completely paralyzed. Orit may be hard for the muscles to work together.

Dysarthria may be the result of brain damage due to:

• Brain injury
• Brain tumor
• Dementia
• Disease that causes the brain to lose its function (degenerative brain disease)
• Multiple sclerosis
• Parkinson disease
• Stroke

Dysarthria may result from damage to the nerves that supply the muscles that help you talkor to the muscles themselves from:

• Face or neck trauma
• Surgery for head and neck cancersuch as partial or total removal of the tongue or voice box

Dysarthria may be caused by diseases that affect nerves and muscles (neuromuscular diseases):

• Cerebral palsy
• Muscular dystrophy
• Myasthenia gravis
• Amyotrophic lateral sclerosis (ALS)or Lou Gehrig disease

Other causes may include:

• Alcohol or illegal drug or medicine intoxication
• Poorly fitting dentures
• Side effects of medicines that act on the central nervous systemsuch as narcoticsphenytoinor carbamazepine

Depending on its causedysarthria 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 stuffyhoarsestrainedor breathy voice

A person with dysarthria may also drool and have problems chewing or swallowing. It may be hard to move the lipstongueor jaw.

Your 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 procedurea flexible viewing scope is placed in the mouth and throat to view the voice box.

Tests that may be done if the cause of the dysarthria is unknown include:

• Blood tests for toxins or vitamin levels
• Imaging testssuch as an MRI or CT scan of the brain or neck
• Nerve conduction studies and electromyogram to check the electrical function of the nerves or muscles
• Swallowing studywhich may include x-rays and drinking a special liquid

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 techniquesif needed
• To avoid conversations when you are tired or eating
• To repeat sounds over and over again so you can learn mouth movements
• To speak slowlyuse a louder voiceand 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 speechsuch 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:

• 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.

Depending on the cause of dysarthriasymptoms may improvestay the sameor 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 worseand may improve.
• Dysarthria after surgery to the tongue or voice box should not get worseand may improve with therapy.

Contact your provider if you have:

• Chest painchillsfevershortness of breathor other symptoms of pneumonia
• Coughing or choking
• Difficulty speaking to or communicating with other people
• Feelings of sadness or depression

Impairment of speech; Slurred speech; Speech disorders - dysarthria

Ambrosi DLee YT. Rehabilitation of swallowing disorders. In: Cifu DXed. Braddom's Physical Medicine and Rehabilitation. 6th ed. PhiladelphiaPA: Elsevier; 2021:chap 3.

Kirshner HS. Dysarthria and apraxia of speech. In: Jankovic JMazziotta JCPomeroy SLNewman NJeds. Bradley and Daroff's Neurology in Clinical Practice. 8th ed. PhiladelphiaPA: Elsevier; 2022:chap 14.

Updated by: Joseph V. CampelloneMDDepartment of NeurologyCooper Medical School at Rowan UniversityCamdenNJ. Review provided by VeriMed Healthcare Network. Also reviewed by David C. DugdaleMDMedical DirectorBrenda ConawayEditorial Directorand the A.D.A.M. Editorial team.