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ABSTRACT

The cervical spine is critical for speech and swallowing functions due to its role in motor control and sensory innervation of associated muscles. Degenerative cervical myelopathy (DCM), often caused by age-related changes, can affect motor and sensory pathways, leading to neurologic impairments. Anterior cervical discectomy and fusion (ACDF) is a common surgical intervention for DCM, but it may cause complications such as dysphonia and dysphagia. Co-occurrence of motor neuron disease (MND) and DCM is rare, presenting unique challenges for diagnosis and management. Objective: This case study highlights the diagnostic and therapeutic role of speech-language pathologists (SLPs) in addressing speech and swallowing impairments in a patient with MND secondary to DCM. Methods: A 43-year-old male underwent ACDF for DCM and was later diagnosed with MND. Detailed speech, language, and swallowing assessments revealed severe mixed dysarthria with preserved language and swallowing skills. A multimodal intervention incorporating non-speech and speech-oriented oromotor exercises (NSOMEs and SOMEs) was implemented to target hypernasality, breath support, and speech intelligibility. Results: Post-therapy, the patient demonstrated improved speech intelligibility and communicative attempts, though articulatory precision and hypernasality persisted. Home training was recommended as the patient discontinued formal therapy. Conclusion: This case underscores the importance of early, multidisciplinary management for individuals with dual diagnoses of MND and DCM. Tailored SLP interventions can enhance functional communication, highlighting the need for vigilance and prompt therapeutic action in complex neurological conditions.

Keywords: Dysarthria, DCM, speech therapy, communication challenges, India