HealthMap

Bulbar Onset ALS and Dysarthria

Overview

• Bulbar onset Amyotrophic Lateral Sclerosis (ALS) primarily affects the motor neurons controlling the muscles of the head, neck, face, throat, and tongue.
• Unlike limb onset, it typically begins with difficulties in speech, chewing, and swallowing rather than hand or leg weakness.

Specific Dysarthria Symptoms

• Slurred Speech: Difficulty articulating words clearly due to weakness, stiffness, or lack of coordination in the tongue, lips, and palate.
• Changes in Vocal Quality:
• A nasal tone resulting from weakness in the soft palate, which fails to close off the nasal cavity properly during speech.
• A hoarse, strained, or breathy voice caused by impaired vocal cord control.
• Reduced Speaking Volume (Hypophonia): Inability to project the voice adequately due to weakened respiratory support or laryngeal muscle involvement.
• Slowed Speech Rate: Difficulty moving the articulators quickly enough, leading to a deliberate, labored cadence.
• Fatigue with Speaking: Speech deterioration that worsens significantly as conversation continues and the facial and vocal muscles tire.