Upper motor neuron symptoms |
Jaw stiffness with difficulty opening the mouth |
Spontaneous clenching or biting |
Trismus |
Spontaneous jaw clonus |
Dysphagia |
Tongue incoordination disrupts the oral phase |
Pharyngeal muscle incoordination disrupts the pharyngeal phase |
Dysarthria |
Labial, lingual, and/or pharyngeal components |
Spastic with slow, strained speech |
Laryngospasm |
Often triggered by secretions (eg, saliva) or food particles |
Rapid onset |
"Squeezing" feeling, inability to speak, strained speech |
Short-lived, less than 30 seconds |
Pseudobulbar affect |
Inappropriate laughing, crying, and/or yawning |
Affective response >> emotional trigger |
Mood incongruent |
Sialorrhea (drooling) |
Difficulty managing pharyngeal secretions |
Lower motor neuron symptoms |
Incomplete eye closure |
Difficulty opening and/or closing the jaw |
Difficulty chewing |
Disarticulation of the temporomandibular joint when severe |
Poor lip closure and seal |
May contribute to sialorrhea when severe |
Dysphagia |
Tongue weakness disrupts the oral phase |
Pharyngeal muscle weakness disrupts the pharyngeal phase |
Coughing and choking induced by drinking, eating, or saliva secretion |
Often thin liquids followed by solids and thick liquids |
Dysarthria |
Labial, lingual, and/or pharyngeal components |
Slurred, nasal, and/or hoarse speech |
Hoarseness |