[Multiple system atrophy speech assessment: study of five cases].

Multiple system atrophy (MSA) is characterized by parkinsonian, cerebellar and pyramidal features along with autonomic dysfunction in different combinations. Onset of dysarthria during the first year of the manifestation of a parkinsonian syndrome suggests the diagnosis of MSA. The aim of this study was to characterize the voice and the speech of patients with MSA. We studied five MSA patients with a mean age of 51.2 years. Each patient was submitted to a neurological and a specific speech and voice assessment. The latter consisted of the following: clinical interview, myofunctional examination, and perceptual speech evaluation. Speech and voice complaints occurred at an average time of 1.1 year after the onset of the motor symptomatology. All MSA patients had the mixed type of dysarthrophonia, where hypokinetic, ataxic and spastic components were seen in each of the patients, although hypokinetic component predominated among the others. Our findings are different from what is commonly seen in Parkinson's disease in which hypokinetic component is the only abnormal finding. We think that specific speech and voice assessment is important to establish the diagnosis and to choose the best management of MSA patients.