Differential diagnosis of dysarthria and dysphagia

from Continuum 2009
1. ALS
2. MG
3. Stroke
4. Syringomyelia
5. Kennedy syndrome
6. GBS/CIDP
7. Myopathy/botulism


Pearls
1. Dysarthia of MG is nasal, with slurred , nasal but not spastic speech, weak tongue movements but not arduous movements of tongue. In ALS, speech is slow and effortful, has a spastic quality as well, slow and effortful speech with a strangled quality. In ALS initial weakness may be described as a tickle in throat or inability to clear mucus , which is not typical of MG. MG patients may have nasal regurgitation, trouble with food not going down or getting stuck. Choking or weight loss also are typical of ALS.