Case report on dysarthria in concomitant autoimmune diseases

Case Presentation: This study reports the case of a 43-year-old woman with complaints of speech difficulties and a diagnosis of dysarthria due to Multiple Sclerosis, Sjögren's Syndrome, Raynaud's Phenomenon, Systemic Lupus Erythematosus and Hashimoto's Thyroiditis. Over 6 years, analyzes were carried out: perceptual of voice with GRBASI (grade, roughness, breathiness, asthenia, strain, instability); voice objective by Praat software, and the patient’s opinion about speech using Voice-Related Quality of Life Protocol (VRQOL), composed of ten items covering two domains: physical functionality and socioemotional. She responded on a scale from 1 to 5, the frequency at which particular event occurred, where 1 was equivalent to “it never happens and it is not a problem” and 5 “it always really happens and it is a bad problem”. The protocol provides a total score ranging from 0 to 100 (from the worst to the best quality of life) and a score for each domain. Discussion: During the period, the patient sought speech therapy support annually and reported symptoms of low and hoarse voice, slurred speech and tiredness when speaking. Negative impact on quality of life was self-reported in the presence of speech difficulties, with mean scores in the VRQOL domains: total = 75, physical = 71, and socioemotional = 82. The most frequent vocal signs were hoarse and breathy quality, asthenia and marked instability, reduced intensity (56 decibels), slowed speech, and imprecise articulation, characterizing mixed dysarthria. The signs and symptoms presented intermittent manifestations and variable in magnitude. Final Comments: The coexistence of autoimmune diseases triggers variable mixed dysarthria that can affect verbal communication and family, social and professional interaction, as well as compromising quality of life. Considering the complexity of these chronic diseases, periodic specialized speech therapy monitoring is recommended for analysis of speech subsystems, guidance, and personalized approaches to circumvent the symptoms.