Goldstein, Norman

Less than half of a series of 168 patients with multiple sclerosis presented significant speech deviations. The most frequent speech deviations observed were impaired loudness control and harshness; less frequently occurring deviations were defective articulation, restricted use of vocal variations for emphasis, poor pitch control, hypernasality, inappropriate pitch level, and breathiness. “Scanning speech” was not a prominent characteristic. Speech deviations were not solely attributable to cerebellar involvement. Their incidence was positively related to severity of neurologic involvement, becoming more prominent as additional motor systems were implicated.

Three judges rated a number of speech characteristics of 20 patients with Wilson’s disease, an inherited metabolic disease. The perceptual data suggest the presence of a mixed dysarthria with prominent ataxic, spastic, and hypokinetic features which were predictable from neurologic data on the patients. Perceptual data on 10 patients, recorded at two specific points in a treatment program, indicate that speech can be used as an effective monitor of progress in the treatment of this disease.