grimacing

Map Branches

• Extrapyramidal
  • disorders
    • Dyskinetic CP
    • athetoid CP
  • presentation
    • feeding reflexes
      • airway protected?
        • Change with
    • involuntary movements
      • speech interference
        • explosive speech
        • on ingressive airstream?
        • errors in
          • consonants
          • vowels
      • head and limbs
        • grimacing
        • torsion movements
    • severe population:
      • speechlessness
  • Hypokinetic dysarthria
    • unusual in kids
    • parkinsonian 
      • expressionless face
      • prosody
• Upper Motor Neurone
  • Spastic
    • pseudo-bulbar palsy
    • presentation
      • jaw
        • stiff
        • +/- clonus
        • Brisk jaw jerk
      • tongue
        • small
        • bunched
        • Limited ROM
      • Oral cavity
        • drooling
      • speech subsystems
        • respiration
          • poor breath control
        • phonation
          • hoarse voice
        • articulation
          • slow
          • effortful
          • consonants
            • imprecise
            • Slurred
        • Prosody
          • control
            • rhythm
            • Stress
• Lower Motor Neurone
  • note
    • clinical presentation
      • hypernasal
      • Stridor
        • VF affected
      • Fasciculations
      • Tongue wasting
      • Depressed reflexes
      • Lax open mouth
      • droopy face
    • indicator
      • progressive disease
  • impairments
    • speech
    • drooling
    • swallowing
      • nasal reflux
      • aspiration
    • feeding
      • chewing
      • biting
  • features:
    • localised
      • individual CNs
    • generalised
      • mastication
      • Swallowing
      • speech
  • Aetiology
    • LMN disease
      • Moebius Syndrome
      • Nemaline Myopathy
      • myasthenia gravis
  • flaccid
• Cerebellar
  • Ataxic
    • Contrast LMN
      • preservation
        • Protective reflexes
        • Chew
        • Swallow
        • bite
    • Resembles LMN

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