Enderby Pam
Department of Rehabilitation and Assistive Technology, University of Sheffield, Sheffield, UK.
Handb Clin Neurol. 2013;110:273-81. doi: 10.1016/B978-0-444-52901-5.00022-8.
Dysarthria is a motor speech disorder which can be classified according to the underlying neuropathology and is associated with disturbances of respiration, laryngeal function, airflow direction, and articulation resulting in difficulties of speech quality and intelligibility. There are six major types of dysarthria: flaccid dysarthria associated with lower motor neuron impairment, spastic dysarthria associated with damaged upper motor neurons linked to the motor areas of the cerebral cortex, ataxic dysarthria primarily caused by cerebellar dysfunction, and hyperkinetic dysarthria and hypokinetic dysarthria, which are related to a disorder of the extrapyramidal system. The sixth is generally termed a mixed dysarthria and is associated with damage in more than one area, resulting in speech characteristics of at least two groups. The features of the speech disturbance of these six major types of dysarthria are distinctive and can assist with diagnosis. Dysarthria is a frequent symptom of many neurological conditions and is commonly associated with progressive neurological disease. It has a profound effect upon the patient and their families as communication is integrally related with expressing personality and social relationships. Speech and language therapy can be used to encourage the person to use the speech that is already available to them more effectively, can increase the range and consistency of sound production, can teach strategies for improving intelligibility and communicative effectiveness, can guide the individual to use methods that are less tiring and more successful, and can introduce the appropriate Augmentative and Alternative Communication approaches as and when required.
构音障碍是一种运动性言语障碍，可根据潜在的神经病理学进行分类，与呼吸、喉功能、气流方向和发音障碍相关，导致语音质量和可懂度出现问题。构音障碍主要有六种类型：与下运动神经元损伤相关的弛缓性构音障碍、与连接大脑皮质运动区的上运动神经元受损相关的痉挛性构音障碍、主要由小脑功能障碍引起的共济失调性构音障碍、与锥体外系疾病相关的运动过多性构音障碍和运动过少性构音障碍。第六种通常称为混合性构音障碍，与多个区域受损有关，导致至少两组的语音特征。这六种主要类型的构音障碍的言语障碍特征各不相同，有助于诊断。构音障碍是许多神经系统疾病的常见症状，通常与进行性神经系统疾病相关。它对患者及其家人有深远影响，因为沟通与表达个性和社会关系密切相关。言语和语言治疗可用于鼓励患者更有效地运用已有的言语能力，增加发声的范围和一致性，教授提高可懂度和沟通效果的策略，指导患者采用不那么费力且更有效的方法，并在需要时引入适当的辅助和替代沟通方法。
