Speech therapy is recommended for people with Lambert-Eaton myasthenic syndrome (LEMS) who experience problems with speech, chewing, and swallowing because of muscle weakness and stiffness. Dry mouth and breathing problems also can contribute to speech problems.
Speech problems in LEMS
Speech problems in LEMS patients occur because the signaling between the nerve cells and the muscles of the face, tongue, and larynx is disrupted.
How speech therapy can help LEMS patients
Speech and language pathologists (SLPs) or speech therapists first assess speech, language, cognitive-communication, and oral feeding and swallowing skills to identify problems in articulation, fluency, voice, receptive and expressive language disorders, and food and fluid ingestion. Based on these evaluations, they recommend the best way to treat any problems.
In general, the speech therapist can do or recommend one or more of the following:
- Teaching exercises that can strengthen the muscles of the mouth. These include facial massage, and various exercises for the tongue, lips, and jaws.
- Educating family members and caretakers to make them aware of how to help the patient with speech and eating issues.
- Helping individuals with LEMS to move their facial muscles correctly to improve speech and make it more clear. Patients may need to retrain their oral muscles to produce sounds. Most commonly, this process will involve repeating sounds over and over again, and practicing correct mouth movements.
- Working on slowing down speech and using more breath so as to speak louder.
- Suggesting other ways to communicate such as augmentative and alternative communication (AAC). AAC may involve aided and unaided approaches. Unaided systems do not use any equipment, but include body language and gestures. Aided systems may include pictures, objects, and letter boards, or technological options such as iPad or Android apps. Specialized computer systems also may help with communication.
For issues with swallowing, SLPs can recommend:
- Exercises that target facial or throat muscles, which are used to chew and swallow.
- Better ways of sitting and holding the head while eating, which can help with swallowing.
- Alternative diet and food textures that are easier to swallow, including softer and warmer food and thicker fluids.
Last updated: Sept. 17, 2019
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