vi Diagnosing Dysarthria in Adults 4.2.2. Breathing and phonation ......................................................... 44 4.2.3. Nasality . ................................................................................. 46 4.2.4. Consonant and vowel length . .................................................. 46 4.2.5. Reading aloud ......................................................................... 46 4.2.6. Question asking . ..................................................................... 47 4.2.7. Sentence repetition .................................................................. 47 4.2.8. Handwriting . .......................................................................... 47 4.2.9. Additional tests ....................................................................... 48 5. Dysarthria In Various Neurological Diseases ........................................ 50 5.1. Dysarthria accompanying motor neuron diseases (MNDs) . ................ 51 5.1.1. Flaccid dysarthria in MND ...................................................... 53 5.1.2. Spastic dysarthria in MND ...................................................... 56 5.1.3. Mixed flaccid–spastic dysarthria in MND ................................ 58 5.2. Dysarthria accompanying Parkinson disease (PD) .............................. 61 5.2.1. Hyperkinetic dysarthria with hypokinetic elements in PD ....... 62 5.2.2. Hypokinetic dysarthria in PD .................................................. 64 5.2.3. Severe hypokinetic–hyperkinetic dysarthria in PD ................... 67 5.3. Dysarthria accompanying Parkinsonism ............................................. 68 5.3.1. Example of hypokinetic dysarthria in Parkinsonism . ................ 68 5.4. Dysarthria accompanying Huntington disease (HD) .......................... 69 5.4.1. Hyperkinetic (dyskinetic) dysarthria in HD in older age .......... 71 5.4.2. Dysarthria in the juvenile form of HD ..................................... 73 5.5. Dysarthria accompanying laryngeal dystonia: various dysarthric forms depending on etiology .............................................................. 76 5.6. Dysarthria accompanying multiple sclerosis ....................................... 80 5.6.1. Example of ataxic–spastic dysarthria in MS .............................. 81 5.7. Dysarthria accompanying spinocerebellar ataxia . ............................... 83 5.8. Dysarthria accompanying progressive supranuclear palsy ................... 86 5.9. Dysarthria accompanying multiple-system conditions ........................ 88 5.9.1. Ataxic–spastic–hypokinetic dysarthria in disorder of pyramidal, extrapyramidal and cerebellar systems ................ 88 5.9.2. Ataxic–spastic dysarthria in multiple-system atrophy (MSA) . .. 90 5.10. Summary of diagnostic cases . ............................................................ 91 CONCLUSIONS . ......................................................................................... 94 Appendix ...................................................................................................... 95 Speech Assessment Method (SAM) ................................................................ 97 References ..................................................................................................... 104 Further reading ............................................................................................. 107 Index . ........................................................................................................... 109
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