To the Editor.
—An impairment of speech production can accompany a lesion of the seventh cranial nerve, producing paresis of facial muscles. The patients may become aware of their difficulties in speech production, particularly during telephone conversations when they may have to repeat themselves several times to be understood. The dysarthria is also apparent to the examining physician, raising the possibility that a brain-stem lesion is the cause of the speech disorder with the facial paresis being a separate manifestation of the central pathology. Several years ago, one of my patients with Bell's palsy and speech impairment showed me a method for transiently alleviating the dysarthria that has stood the test of time as a means for assuring myself that the patient's speech production problems were due to weakness of the perioral facial muscles and not to a disorder of central processes governing speech production. The patientTo show maneuver
Starr A. Distinguishing and Improving Dysarthria due to Facial Weakness. Arch Neurol. 1989;46(2):125. doi:10.1001/archneur.1989.00520380025006
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