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Constant tongue movements, lower speech volume. slurring words

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#1 Beau's Mom

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Posted 15 January 2011 - 07:52 PM

I was diagnosed with Parkinson's in December 2010, but have had symptoms for about ten years. For the last six months or so, I have noticed that my tongue moves constantly in my mouth. It looks OK but feels sore and swollen. Sometimes I feel like I am slurring my words or stumbling over my tongue. For the past two years I've been asking my husband to have his hearing checked and he insists that I talk too softly. Most others hear me fairly well but sometimes ask me to repeat myself. This has caused friction with my husband. Any suggestions? My neurologist tells me I don't need speech therapy and doesn't know what to do about my tongue movements.


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#2 Dr. Mahler

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Posted 18 April 2011 - 10:59 AM

I am glad you wrote about whether receiving speech treatment is appropriate for you.

Without seeing you in person for an evaluation, it is difficult for me to diagnose the exact nature of your tongue and speech problem. However, I can tell you that approximately 75-90% of individuals with Parkinson disease (PD) have speech and voice disorders at some time in the course of their disease. The most common perceptual speech characteristics include reduced loudness, monopitch, hoarseness, a breathy voice quality and/or imprecise articulation.

As you have experienced first hand, speech symptoms associated with PD can have a significantly negative impact on quality of life. The presence of speech disorders can effect communication at work, with family
or with friends. Seeking an evaluation with a speech-language pathologist experienced with PD as early as possible is important so you can begin an effective treatment program.

Although the incidence of speech and swallowing disorders in PD is high, the referral rate to speech-language pathologists for treatment is relatively low. One reason for the low referral rate is that the average age of diagnosis of PD is 60 so the perception is that speech and voice changes are just the result of normal aging. However, a study by Fox & Ramig (1997) demonstrated that people with PD were statistically significantly softer than healthy age-matched controls. In addition, studies of electromyography demonstrated that people with PD have less muscle stimulation to the thyroarytenoid muscles than healthy age-matched controls. A study by Baker et al., (1998) compared EMG activity of the thyroarytenoid muscles between young, healthy aged and people with PD. They found that EMG activity of people with PD was significantly less during a variety of phonatory tasks than for the healthy age-matched participants. In a swallowing study comparing people with PD to healthy controls it was found that people with PD swallowed more often during inhalation and at low tidal volumes than healthy age-matched controls placing them at greater risk for aspiration (Gross, Atwood, Ross, Eichorn, Olszewski, & Doyle, 2008). Also, physicians are not always aware that there are behavioral treatments that can improve speech and swallowing for people with PD.

I suggest you see a speech-language pathologist for a recommendation about whether there is a treatment that can help you.

Leslie Mahler, PhD, CCC-SLP

Associate Professor

University of Rhode Island

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