Approach to dysarthria or dysphagia Quiz: Ace Your Exams
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A 66-year-old man presents to the primary care clinic for evaluation of weakness for the past six months. The patient has noticed difficulty getting out of a chair and using his hands. More recently, the patient has been choking while eating. The patient has not seen a physician in many years and does not take any daily medications. There is no history of substance use. Review of systems includes unintentional weight loss. Temperature is 37.0°C (98.6°F), pulse is 80/min, respirations are 14/min, and blood pressure is 135/82 mmHg. On examination, the patient appears thin with breathy, hypernasal, slow, slurred speech. There is tongue atrophy and fasciculations. Generalized weakness, muscle atrophy, spasticity, and hyperreflexia are present. An electromyogram reveals fibrillation and fasciculation potentials with abnormal recruitment. Which type of speech dysfunction is most commonly associated with the likely underlying condition?
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