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Dysarthria occurs in more than 80% of ALS patients and may cause major disability, earlier in those with bulbar onset who may become anarthric after a few months (Tomik and Guiloff 2010). 

Tomik and Guiloff 2010

Careful neurological examination, including cranial nerves, and monitoring the rate of progression in affected muscles are important. Loss of communication prevents ALS patients from participating in a number activities and leads to social isolation. Dysarthria significantly reduces the quality of life of ALS patients.

Andersen and others 2007

Language impairment can have a deleterious effect on the quality of life of the patients and carers, and can make the clinical management of the patient difficult.

When dysarthria progresses the use of an augmentative and alternative communication (AAC) system is needed. An AAC system substantially improves the quality of life.

For ventilated patients eyepointing or eye-gaze augmentive high-tech communication devices are useful. Brain-computer interfaces, EEG & EP (SCP) methods, and thought translation devices can be used as the new communication channels.

Miller and others 2009b

What treatments for dysarthria optimize communication in ALS?

  • Communication is fundamental to effective participation in life, especially sharing social closeness. Strategies for communication with patients with ALS include an alphabet board, computerized systems, Morse code, utilization of the anal sphincter, and infrared eye movements.
  • Conclusion
    • No controlled studies examined communication in ALS
  • Recommendation
    • There are insufficient data to support or refute treatment to optimize communication in ALS (Level U).

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