NEUROLOGIC DISORDERS AFFECTING SPEECH & SWALLOWING  |  Conditions We Treat

Parkinson’s disease is a neurological disorder that targets bring cells that control movement.

What are the symptoms?
Symptoms include tremors, stiffness and poor balance, as well as dementia or depression. Often some of the first changes to be recognized are a change in voice clarity and vocal volume. Patients can also develop difficulty swallowing and difficulty breathing as the condition progresses.

Who is affected?
The disease, which affects about 1 million people in the United States, targets neurons that produce an important chemical called dopamine. Dopamine is a chemical messenger that transmits signals within the brain. Normally, dopamine operates in a delicate balance with other neurotransmitters to help coordinate the millions of nerve and muscle cells involved in movement. Because Parkinson's patients have a loss of dopamine-producing cells in the brain, the coordination among nerve and muscle cells is disrupted. The cause of the disease is unknown.

What is the effect?
Parkinson’s disease damages nerves in the brain and body. It also weakens the muscles required for speech. That can cause several problems:

• A soft, breathy or hoarse voice
• “cluttering” or rapid, stammering speech
• Slurred speech
• Choking with drinking or eating

How is it treated?
Therapy is essential for patients diagnosed with Parkinson’s disease. Physical therapy can improve walking. Occupational therapy helps with activities of daily living like getting dressed and eating. Speech and swallow therapy are helpful for maintaining communication skills and the ability to eat.

Speech and swallow therapy programs for Parkinson’s disease include:

• Lee Silverman Technique (LSVT) is a proven rehabilitation method, with long lasting results, in treating speech disorders in people with Parkinson’s Disease. Treatment targets loud, clear speech. The benefits include improved loudness, improved articulation speech intelligibility, improved intonation, improvements in facial expressions, and changes in neural functioning related to voice and speech.
• Group therapy to practice speech techniques
• These therapies work in several ways: strengthening the muscles involved in speech through a range of exercises. They train patients to speak at a normal volume. Parkinson’s causes “feedback mismatch” that makes patients feel like they’re shouting. Therapeutic approaches are intended to show patients the difference between perception and reality by playing recordings of their own voice. Additionally, therapy can improve pace. When you speak louder, you naturally speak more slowly. The muscle strength improvements even help with swallowing. It is shown to improve articulation and facial expression.

Here at the Ark-LA-Tex Center for Voice, Airway and Swallowing we enjoy a close collaboration and multidisciplinary approach to movement disorders with the neurology department and nutrition.

Amyotrophic lateral sclerosis (ALS), also known as Lou Gehrig's disease, is a progressive degeneration of nerve cells that control muscle movements. The disease, the most common motor neuron disease among adults, became known as Lou Gehrig's disease after the New York Yankee's Hall of Fame first baseman. Gehrig's career ended in 1939 because of the condition.

Who is affected?
About 30,000 patients in this country have the disease and about 5,000 are diagnosed with ALS every year. ALS tends to strike in mid-life between the ages of 40 and 60, but others can develop the disease. Men are about one-and-a-half times more likely to have the disease than women. In most cases, it occurs at random with no family history of the disease.

What is the effect?
ALS attacks nerve cells and pathways in the brain and spinal cord, causing the body's motor neurons to waste away. The result is progressive muscle weakness and in coordination, causing difficulty with mobility, speaking, swallowing and breathing.

How is it treated?
Proper medication and physical therapy, however, can help control symptoms and allow patients to lead more independent lives.

Here at the Ark-LA-Tex Center for Voice, Airway and Swallowing we offer a Multidisciplinary approach to the care of patients with ALS. We work closely with neurology and pulmonology to help patients determine:

• Need for speech and swallow therapy
• Readiness for tracheostomy
• Readiness for alternative means of nutrition including feeding tube/G-tube

Stroke can damage or cause a malfunction in the brain or nervous system. When the brain doesn’t receive the oxygen-rich blood it needs, and brain cells start to die there can be lasting implications for speech and swallowing function.

What are the symptoms?
Speech symptoms can fall into two main categories:

• Dysarthria – a difficulty in forming or pronouncing words correctly
• Mechanical speech disorder- a malfunction of the tongue and lips, inhibiting the ability to form words at all.

These disorders may make it difficult for patients to communicate with caretakers or loved ones, potentially leading to depression or oversite of disease progression. It is common after a neurologic event like a stroke to have changes in swallowing function or difficulty swallowing.

How is it treated?
Swallowing therapy with our Speech Language Pathologist is a mainstay of treatment

Here at the Ark-LA-Tex Center for Voice, Airway and Swallowing we provide state-of-the-art evaluation and treatment of conditions affecting the voice and swallowing, including options that don't require hospitalization, such as integrative and complementary medicine techniques.