From the Guidelines
Voice changes due to internal capsule stroke are typically characterized by dysarthria, which can be effectively managed with speech therapy focused on strengthening oral muscles, improving articulation, and developing compensatory strategies, as recommended by the American Heart Association/American Stroke Association guidelines 1. The internal capsule contains motor fibers that control the muscles involved in speech production, including those of the tongue, lips, jaw, and vocal cords. When a stroke affects this area, particularly the posterior limb of the internal capsule, patients may experience weakness or impaired coordination of these speech muscles, resulting in slurred, slow, or imprecise speech. This condition is often called "capsular dysarthria" and may be accompanied by other motor deficits on the contralateral side of the body.
Key Considerations
- Dysarthria can affect any of the subsystems underlying speech production, including the respiratory, laryngeal, velopharyngeal, and oral-articulatory subsystems 1.
- The presence of a communication disorder, such as dysarthria, may negatively affect social participation, psychosocial well-being, and quality of life 1.
- A certified speech and language pathologist normally performs the evaluation and treatment of communication disorders, with the overall goals of speech and language treatment being to facilitate the recovery of communication, to assist patients in developing strategies to compensate for communication disorders, and to counsel and educate people in the patient’s environment on assistive communication supports 1.
Treatment and Recovery
- Treatment typically involves speech therapy focused on strengthening oral muscles, improving articulation, and developing compensatory strategies, with sessions 2-3 times weekly for several months 1.
- Recovery potential depends on the extent of damage, with some patients showing significant improvement within the first few months post-stroke.
- The neurological basis for these voice changes involves disruption of the corticobulbar tracts that carry motor signals from the cortex to the brainstem nuclei controlling speech muscles, unlike cortical strokes that may cause language processing problems, internal capsule strokes primarily affect the mechanical aspects of speech production while language comprehension and formulation typically remain intact.
From the Research
Voice Changes Due to Internal Capsule Stroke
- There is limited research directly addressing voice changes due to internal capsule stroke.
- However, studies have investigated the effects of internal capsule stroke on various neurological functions, including motor and sensory symptoms 2.
- A study on acute isolated capsular stroke found that limb weakness, sudden onset, and sensory symptoms were independently associated with capsular hemorrhage, whereas pure motor hemiparesis appeared to be associated with capsular infarction 2.
- Another study examined the structural and functional reorganization following unilateral internal capsule infarction and its contribution to neurological function recovery, but it did not specifically address voice changes 3.
- Research on pharmacotherapy for secondary stroke prevention and antiplatelet therapy may provide indirect insights into the management of stroke, including internal capsule stroke, but does not directly address voice changes 4, 5, 6.