If a speech problem exists, a key question is whether dysarthria, a disorder of the motor mechanism of articulation, may result from either cerebellar dysfunction or from primary motor dysfunction. The character of the dysarthria is different, and dependent upon the cause. Cerebellar disease may produce an abnormality in cadence of speech, while motor dysfunction produces abnormalities in enunciation. Examples of words or phrases that when rapidly spoken demonstrate a subtle dysarthria are: "Seventy-Seven Register Street" and "Methodist Episcopal." Alert, aware, dysarthric patients may be able to tell you that their speech is different than usual.

Dysphasia is a disorder of the normal cerebral processing of speech by which meanings are comprehended and expressed. The defect may be in finding words or names, with or without difficulty in writing, but without defect in comprehension (expressive dysphasia); or a difficulty in understanding spoken or written speech (receptive dysphasia); or a more diffuse difficulty in the appreciation of word sounds and grammatical construction, with or without a defect in manipulating numbers, with or without a jumbling of spoken words (jargon speech). In expressive dysphasia, the abnormality lies in executing speech and may be obvious. Asking the patient to name several objects, or to tell the name of parts of a watch or articles of clothing, may elucidate a mild dysnomia. On the other hand, the receptive dysphasic patient does not understand speech and may not understand written language. Many dysphasic patients have abnormality in both executing (expressive dysphasia) and understanding speech (receptive dysphasia).

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