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影响言语和吞咽功能的多动障碍的言语语言病理学评估与管理

Speech-Language Pathology Evaluation and Management of Hyperkinetic Disorders Affecting Speech and Swallowing Function.

作者信息

Barkmeier-Kraemer Julie M, Clark Heather M

机构信息

Division of Otolaryngology, University of Utah, Salt Lake City, UT, USA.

Department of Neurology, Mayo Clinic, Rochester, MN, USA.

出版信息

Tremor Other Hyperkinet Mov (N Y). 2017 Sep 21;7:489. doi: 10.7916/D8Z32B30. eCollection 2017.

Abstract

BACKGROUND

Hyperkinetic dysarthria is characterized by abnormal involuntary movements affecting respiratory, phonatory, and articulatory structures impacting speech and deglutition. Speech-language pathologists (SLPs) play an important role in the evaluation and management of dysarthria and dysphagia. This review describes the standard clinical evaluation and treatment approaches by SLPs for addressing impaired speech and deglutition in specific hyperkinetic dysarthria populations.

METHODS

A literature review was conducted using the data sources of PubMed, Cochrane Library, and Google Scholar. Search terms included 1) hyperkinetic dysarthria, essential voice tremor, voice tremor, vocal tremor, spasmodic dysphonia, spastic dysphonia, oromandibular dystonia, Meige syndrome, orofacial, cervical dystonia, dystonia, dyskinesia, chorea, Huntington's Disease, myoclonus; and evaluation/treatment terms: 2) Speech-Language Pathology, Speech Pathology, Evaluation, Assessment, Dysphagia, Swallowing, Treatment, Management, and diagnosis.

RESULTS

The standard SLP clinical speech and swallowing evaluation of chorea/Huntington's disease, myoclonus, focal and segmental dystonia, and essential vocal tremor typically includes 1) case history; 2) examination of the tone, symmetry, and sensorimotor function of the speech structures during non-speech, speech and swallowing relevant activities (i.e., cranial nerve assessment); 3) evaluation of speech characteristics; and 4) patient self-report of the impact of their disorder on activities of daily living. SLP management of individuals with hyperkinetic dysarthria includes behavioral and compensatory strategies for addressing compromised speech and intelligibility. Swallowing disorders are managed based on individual symptoms and the underlying pathophysiology determined during evaluation.

DISCUSSION

SLPs play an important role in contributing to the differential diagnosis and management of impaired speech and deglutition associated with hyperkinetic disorders.

摘要

背景

运动过多性构音障碍的特征是异常的不自主运动,影响呼吸、发声和构音结构,进而影响言语和吞咽。言语语言病理学家(SLP)在构音障碍和吞咽困难的评估与管理中发挥着重要作用。本综述描述了SLP针对特定运动过多性构音障碍人群中言语和吞咽受损情况的标准临床评估和治疗方法。

方法

使用PubMed、Cochrane图书馆和谷歌学术等数据源进行文献综述。检索词包括:1)运动过多性构音障碍、原发性语音震颤、语音震颤、发声震颤、痉挛性发音障碍、痉挛性发声障碍、口下颌肌张力障碍、梅杰综合征、口面部、颈部肌张力障碍、肌张力障碍、运动障碍、舞蹈症、亨廷顿舞蹈病、肌阵挛;以及评估/治疗相关词汇:2)言语语言病理学、言语病理学、评估、评定、吞咽困难、吞咽、治疗、管理和诊断。

结果

SLP对舞蹈症/亨廷顿舞蹈病、肌阵挛、局限性和节段性肌张力障碍以及原发性语音震颤的标准临床言语和吞咽评估通常包括:1)病例史;2)在非言语、言语及吞咽相关活动(即颅神经评估)期间,检查言语结构的肌张力、对称性和感觉运动功能;3)评估言语特征;4)患者自我报告其疾病对日常生活活动的影响。SLP对运动过多性构音障碍患者的管理包括针对言语受损和可懂度问题的行为和代偿策略。吞咽障碍根据个体症状以及评估期间确定的潜在病理生理学进行管理。

讨论

SLP在对与运动过多性疾病相关的言语和吞咽受损进行鉴别诊断及管理方面发挥着重要作用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/0033/5628324/48b98b24be23/tre-07-489-7522-1-g001.jpg

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