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PATHOLOGIES (NEURO - DEGENERATIVE (Myasthenia gravis (RoPs (Speech:…
PATHOLOGIES
NEURO - DEGENERATIVE
Myasthenia gravis
Autoimmune disease where signal is disrupted between nerve and muscle. Usually affects muscles that control eye/eyelid movement, facial expressions, and swallowing.
RoPs
Speech: dysarthria caused by droopy mouth, palatal - nasal speech
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Motor Neuron Disease
Umbrella term for group of neurological diseases characterised by progressive degeneration of motor neurons. Muscles then gradually weaken and waste, as neurons degenerate and die
RoPs
Speech (dysarthria). UMN: strained, LMN: slurred. Caused by weakness/paralysis to muscles associated with CN for speech.
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Parkinson's
Progressive NDD with no known cause. Results in tremors, muscular rigidity, difficulty initiating movement and dementia. Substantia nigra of basal ganglia implicated.
RoPs
Speech: hypokinetic dysarthria categorised by hypotonia, monotonicity, hoarseness/breathiness (voice), imprecise articulation, difficulty initiating phonation and speech rate problems
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GB Syndrome
Autoimmune condition where immune system attacks nerves, damaging/destroying myelin sheath and damaging actual axons.
Damage to CNVII and XII. Dysarthria and dysphagia,
Multiple Sclerosis
Demyelinating disease where myelin sheaths of nerves are damaged / deteriorate. Disrupts neuronal communication in CNS and PNS.
RoPs
Speech: ataxic dysarthria, slow slurred speech.
Voice: dysphonia, harsh/hoarse/breathy/nypernasal, reduced loudness, pitch also affected
Language: language processing impairments, expressive aphasia
Swallowing: dysphagia, due to strength/rate/range/coordination of muscles being affected
STROKE
Categories
Ischemic: blood clot, artery to part of brain is blocked. In transient ischemic attacks, blood flow returns without subsequent functional impairment. In infarcts, blood supply is interrupted long enough for brain tissue to die.
Haemorrhagic: break in wall of blood vessel, causing blood to leak into brain. Described by location, e.g. intracerebral, subarachnoid,
Strokes described by location in the brain. All stroke victims will have swallowing assessment. All left middle cerebral artery stroke victims will have language assessment.
L hemisphere strokes often affect language more obviously, while R hemisphere strokes affect paralinguistic features of language (often not picked up my Drs, who just get patient to name things).
Pathologies include dysphagia (60%), dysarthria (20%), aphasia (30%), or MMC (because of limb paresis).
MOTOR LESIONS
Focal damage is concentrated to one area, while diffuse damage is spread throughout brain
UMN: originate either in the motor region of cerebral cortex or in brain stem and carry motor information down to LMNs. Damage causes positive signs. Result of stroke, multiple sclerosis, traumatic brain injury and cerebral palsy.
LMN: located in brainstem, cranial nerve nuclei with motor function (cranial nerve lower motor neurons). Damage causes negative signs. Trauma to peripheral nerves that serve the axons, GB syndrome
TRAUMATIC BRAIN INJURY
Categories
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Close head injury where there is no penetration (results from falls, MVAs, etc). Usually results in frontal lobe, cerebellar pr sub-cortical damage bilaterally.
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Corticospinal / pyramidal tract: from origin primary motor cortex, these nerves pass via the corona radiata to gather in internal capsule before crossing over to opposite side (decussation) in the medullary pyramids and proceeding down the spinal cord to meet lower motor neurons in the anterior grey column. Carry signals for voluntary movement of skeletal muscle.