Anarthria

ANARTHRIA (from Greek a- negative particle, and arthron-joint), loss of ability to form speech sounds; however, a patient suffering from anarthria usually still manages to indistinctly pronounce several syllables or several vowel sounds; often accompanied by a nasal tone and hoarseness of voice. An anarthric person is unable to read aloud or repeat words; the ability to write is usually fully preserved, as is understanding of written and spoken speech; intelligence remains unaffected. Anarthria differs from aphasia in that a patient with motor aphasia does not show paralysis of phonation, tongue, soft palate, orbicularis oris muscle, etc., which occurs in anarthria. Anarthria arises from paralysis or paresis (bilateral) of the muscles involved in articulation, with destructive processes in the pons and medulla oblongata. Thus, anarthria may be observed in lateral amyotrophic sclerosis due to nuclear or supranuclear paralysis of articulation, accompanied in the first case by muscular atrophy and fibrillary twitching in the corresponding muscles (tongue, lips, etc.). Anarthria is also encountered in bulbar paralysis of vascular origin, in syringobulbia, in so-called progressive bulbar and in pseudo-bulbar paralysis. In the latter case, anarthria is not accompanied by muscular wasting, and in the paretic muscles there are no signs of qualitative change in excitability, whereas in anarthria depending on lesions of the nuclei of the medulla oblongata, the paralyzed muscles invariably atrophy. The prognosis of anarthria varies depending on the nature of the underlying condition; it is unfavorable in true bulbar paralysis, in syringobulbia, and in lateral amyotrophic sclerosis; the prognosis is somewhat better in acute pseudo-bulbar paralysis of vascular origin; significant improvement is even possible. In the treatment of anarthria, it is necessary to consider the underlying condition; where some success can be expected, speech orthopedics should be applied.