Scanned speech is a slow, fragmentary, syllable-by-syllable pronunciation of words and phrases. It is a characteristic sign of cerebellar dysfunction, occurs in atactic dysarthria, multiple sclerosis, encephalomyelitis, cerebellar tumors, hereditary ataxias, cerebellar stroke. Diagnosis is aimed at identifying the cause and focus of the lesion in the brain (MRI, CT scan), a speech therapy examination is mandatory. Therapeutic tactics is determined by the underlying pathology, may include pharmacotherapy, neurosurgical intervention, speech therapy.
Scanned speech is a pathognomonic sign of cerebellar dysarthria, which develops when the cerebellum and cortico-cerebellar pathways are involved in the pathological process. In this case, there is a discoordination of movements, including speech organs. The tone of the articulatory muscles is lowered, holding postures is difficult, purposeful movements are impossible. There is a violation of the rhythmic scheme and intonation-melodic pattern of the phrase.
The speech of a patient with cerebellar dysarthria is tense, accompanied by certain efforts, vasomotor reactions (heartbeat, blood pressure fluctuations, sweating). Oral utterance is characterized by the presence of stops, pauses between syllables and words. Scanned speech is fragmentary, jerky, similar to declamation. Sometimes it is called "torn" or "chopped". Voice modulations are disturbed, rhinophony is noted, by the end of the phrase the voice fades. All this entails a decrease in the intelligibility and articulation of speech.
In children, various perinatal complications are risk factors for the occurrence of cerebellar dysarthria:
The pathogenetic basis of multiple sclerosis (MS) is the process of demyelination of the nerve fibers of the brain and spinal cord, the formation of glial scars (plaques) instead of the lost functional tissue. Cerebellar disorders are observed in 60-87% of patients. They include ataxia, asynergy, dysmetria. A specific clinical sign is Charcot's triad, represented by intentional tremor, nystagmus, and chanted speech. Macrography is also characteristic.
Pathology can be caused by thrombosis of the cerebellar artery or hemorrhage into the cerebellar tissue. The clinic of cerebellar stroke consists of atactic syndrome, dizziness, nausea and vomiting, oculomotor disorders (nystagmus, exotropia, diplopia). Speech function is impaired according to the type of cerebellar dysarthria: the patient's speech is not smooth, blurry, with concomitant trembling of the voice. Scanned speech can also be observed in stem stroke.
Cerebellar ataxia
Among the volumetric formations of the cerebellum, there are gliomas, hemangioblastomas, astrocytomas, medulloblastomas, metastatic tumors, etc. Their growth is accompanied by cerebral (cephalalgia, dizziness, nausea) and cerebellar disorders (unsteady gait, posture instability, nystagmus, speech disorders). Speech is syllable-by-syllable, slow, disprosodic.
Damage to the cerebellum can occur after a viral infection: chicken pox, influenza, mumps, infectious mononucleosis, and a number of others. Bacterial complications often develop during the transition of otogenic inflammation to the posterior fossa (for example, with mastoiditis). Sometimes the trigger is vaccination. Scanned speech occurs in the following pathologies:
Genetic syndromes that are accompanied by progressive atrophy of the cerebellum also occur with atactic and dysarthric syndrome. The phenomenon of scanned speech can be determined in a number of hereditary diseases:
The group of diseases caused by pathology of the cerebellum and accompanied by discoordination of movements is combined into a group of cerebellar ataxias. In these cases, speech motility is also impaired, which is manifested by scanned speech. The causes of cerebellar ataxia are varied:
Since scanned speech is a symptom of neurological disorders, the patient is first examined by a neurologist. In addition, consultation of a clinical speech therapist is required, in some cases - a neurosurgeon, genetics. The following types of diagnostics are used:
Ergotherapy
The main attention in patients with speech problems is given to the etiopathogenetic treatment of the causative pathology. Specific tactics depend on the nature of the cerebellar syndrome:
Correction of cerebellar dysarthria is aimed at developing smooth, melodious speech. As rhythm is restored, they proceed to restore the pace and expressiveness of speech. For this purpose, the following are used:
Sometimes (for example, with progressive neurodegenerative diseases), a significant improvement in speech function cannot be achieved. Scanned speech remains with the patient for life.