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Samenvatting Dysartrie 2e jaar HoGent
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Volledige samenvatting van het vak dysartrie.
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NEUROGENE SPRAAK- ENTAALSTOORNISSEN:DYSARTRIE
Louise Vansteenkiste
2020 - 2021
,1 DYSARTRIE ................................................................................................................................ 3
1.1 DEFINITIE .................................................................................................................................. 3
1.1.1 SPRAAKCOMPONENTEN .................................................................................................................... 3
1.2 NEUROMUSCULAIR ..................................................................................................................... 3
1.2.1 PERIFERE DYSARTRIE ........................................................................................................................ 4
1.2.2 CENTRALE DYSARTRIE ....................................................................................................................... 4
1.3 TYPES....................................................................................................................................... 5
1.3.1 SLAPPE OF BULBAIRE DYSARTRIE ......................................................................................................... 5
1.3.2 SPASTISCHE OF PSEUDOBULBAIRE DYSARTRIE........................................................................................ 7
1.3.3 ATACTISCHE OF CEREBELAIRE DYSARTRIE.............................................................................................. 8
1.3.4 HYPOKINETISCHE DYSARTRIE.............................................................................................................. 9
1.3.4.1 Ziekte van Parkinson .............................................................................................................. 12
1.3.4.2 Parkinson plus syndroom: Multiple Systeem Atrofie ............................................................ 13
1.3.5 HYPERKINETISCHE DYSARTRIE .......................................................................................................... 13
1.3.5.1 Ziekte van huntington............................................................................................................ 14
1.3.6 GEMENGDE DYSARTRIE................................................................................................................... 15
1.3.6.1 Amyotroof Lateraal Sclerose (ALS) ........................................................................................ 16
1.3.6.2 Multiple Sclerose (MS)........................................................................................................... 16
1.3.7 UNILATERALE UPPER MOTOR NEURON DYSARTRIE (UUMN)................................................................ 16
1.3.8 ANATRIE P 133 ............................................................................................................................. 17
1.3.8.1 Bi- operculair syndroom ........................................................................................................ 17
1.4 VOORKOMEN VAN DYSARTRIE ..................................................................................................... 17
1.5 GEVOLGEN .............................................................................................................................. 18
1.6 DIAGNOSTIEK........................................................................................................................... 18
1.6.1 INSTRUMENTEEL ONDERZOEK .......................................................................................................... 19
1.7 BEHANDELING .......................................................................................................................... 31
1.7.1 PATIËNTGERICHTE BEHANDELING ..................................................................................................... 31
1.7.1.1 Aanpassen Medicamenteuze behandeling ............................................................................ 31
1.7.1.2 Prothetische behandeling ...................................................................................................... 31
1.7.1.3 Chirurgische behandeling ...................................................................................................... 31
1.7.1.4 Gedragsmatig-logopedische behandeling ............................................................................. 32
1.7.2 OPTIMALISEREN VAN COMMUNICATIEVE SITUATIES ............................................................................. 41
1.7.2.1 Op activiteitniveau................................................................................................................. 41
1.7.2.2 Op participatieniveau ............................................................................................................ 42
1.8 COACHEN ................................................................................................................................ 43
1.9 MATERIAAL VOOR DYSARTRIE EN ZIJN SPRAAKPARAMETERS (PATIËNTGERICHTE BEHANDELING)................. 44
1.9.1 DYSAMIX ..................................................................................................................................... 44
1.9.2 SPRAAKMAKEND SPRAAKVERMAAK ................................................................................................... 44
1.9.3 PROSODIETRAINER ........................................................................................................................ 46
1.9.4 ANDER TOEGANKELIJK MATERIAAL .................................................................................................... 46
2 FACIALISPARALYSE: NERVUS FACIALIS (N.7) ............................................................................ 47
2.1 VERLOOP EXTRA-CRANIAAL ......................................................................................................... 47
2.1.1 FUNCTIES ..................................................................................................................................... 47
2.2 VERLOOP INTRACRANIAAL .......................................................................................................... 48
2.3 OORZAKEN .............................................................................................................................. 49
2.4 GEVOLGEN .............................................................................................................................. 49
2.5 ONDERZOEK ............................................................................................................................ 52
2.6 BEHANDELING .......................................................................................................................... 53
,2.6.1 MEDISCHE BEHANDELING ............................................................................................................... 53
2.6.2 LOGOPEDISCHE BEHANDELING ......................................................................................................... 54
2.7 RICHTLIJNEN ............................................................................................................................ 55
, 1 Dysartrie
1.1 Definitie
Dysartrie = een verzamelterm voor een groep spraakstoornissen
t.g.v. een verstoring in spiercontrole over de spraakmechanismen
door schade aan het centraal of perifeer zenuwstelsel.
Puur motorische stoornis.
Veroorzaakt problemen in de orale communicatie de spraak.
Daarom valt dysartrie onder de motorische spraakstoornissen.
Het komt tot stand door paralyse, zwakte of dyscoördinatie van de
spraakmusculatuur.
Onderscheiden van spraakapraxie en afasie.
Spraakapraxie: problemen met het plannen en programmeren van bewegingen, hetgeen nog
voor het motorische komt.
Afasie: inefficiënte verwerking van linguïstische eenheden
Perifere zenuwen: spinale (12) en craniale (hoofd)zenuwen (16).
Centraal zenuwstelsel: grote, kleine hersenen, hersenstam tot aan ruggenmerg.
1.1.1 Spraakcomponenten
- Ademhaling: type, volume, beheersing
- Fonatie: kwaliteit, toonhoogte, luidheid
- Resonantie
• Hyper- (te veel lucht door de neus naar buiten), hyponasaliteit (te weinig lucht
door de neus naar binnen), gemengd, nasale emissie (hoort de lucht door de
lucht naar buiten gaan.
• Velofaryngale incompetentie of insufficiëntie
- Articulatie/mondmotoriek: hyper-, hypotoon
- Prosodie
• Melodisch (verwijst naar zinsmelodie, vraag of mededelende), dynamisch (de
klemtoon luider, stiller in een zin) en temporeel (sneller en trager spreken)
accent
1.2 Neuromusculair
Bezenuwing spraakspieren zijn gelegen in:
- Centraal zenuwstelsel (CZS)
- Perifeer zenuwstelsel (PZS)
We spreken bij een beschadiging aan het CZS of PZS van een musculaire stoornis.
Bij CZS: Centrale dysartrie
Bij PZS: Perifere dysartrie
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