Dysarthria Dysphonia

Dysarthria (impaired articulation) and dys-phonia (impaired phonation and resonance) result from a disturbance of the neural control mechanism for speech (sensory portion, motor portion, or both). Diagnostic assessment requires both analysis of the patient's vocal output (breathing, phonation, resonance, articulation; speed, coordination, and prosody of speech) and the determination of any associated neurological findings (e.g. dysphagia, hyperkinesia, cranial nerve deficits). For responsible lesions and syndromes, see Table 12 (p. 365).

Thalamocortical projections

Motor cortex

Thalamocortical projections

Motor cortex

Multiple Sclerosis

Facial n.

Glossopharyngeal n. Hypoglossal n.

Recurrent laryngeal n. (passes around subclavian a. on right, around aortic arch on left)

- Trigeminal n. (fibers to muscles of mastication)

Facial n.

Glossopharyngeal n. Hypoglossal n.

Recurrent laryngeal n. (passes around subclavian a. on right, around aortic arch on left)

Neural control of speech (afferent fibers are green)

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