Speech Problems

Your lungs, diaphragm, vocal cords, lips, and tongue all work as a team to help you speak. Fatigue and damage to your central nervous system caused by multiple sclerosis (MS) can impact your voice.

What causes speech problems with MS?

The speech problems that come along with multiple sclerosis may be caused by:^1,2

• Lesions in the brain or spinal cord
• Weakness in the muscles responsible for speech (dysarthria)
• Chest muscle weakness
• Extreme tiredness (fatigue)

Speech problems could worsen during an MS relapse or in the later stages of the illness.

What types of speech problems happen with MS?

Speech problems related to multiple sclerosis range from mild to serious. When they are severe, other people may have trouble understanding what you are saying. Speech problems in people with MS can include:¹

• Scanning speech – MS may interrupt the normal flow or rhythm of speech. This can result in longer than normal pauses between words or syllables.
• Slurring – You may notice you slur your words, which happens because of weakness in tongue, lip, cheek, and mouth muscles.
• Nasal speech – It may sound like you have a cold or stuffy nose.
• Speech volume – When MS weakens your diaphragm, it may be hard to control the volume of your voice.

How are speech problems diagnosed?

A speech-language pathologist may assess how you talk to figure out what type of speech problem you have. Your doctor could also give you a physical exam and run tests to rule out other illnesses. These tests include:³

• MRI or CT scan of your brain, head, and neck
• EEG or EMG, which measures electrical activity in your brain and nerves
• Blood and urine tests to find out if you have an infection or inflammation
• Spinal tap to diagnose an infection, central nervous system disorder, or cancer of the brain and spinal cord
• Tests to check your thinking, reading, and writing skills, and grasp of speech

How are speech problems treated?

While medicine will not treat speech problems, your healthcare team can help improve communication and strengthen speech-related muscles.

Speech, language, and physiotherapy

You may visit a speech and language therapist to manage speech or swallowing issues. These experts may help you:^1,2,4,5

• Practice language exercises to improve speech muscle strength
• Develop strategies for speech improvement, such as talking slowly
• Learn breathing and other exercises to enhance the volume and clarity of your voice
• Find technology tools like smartphone apps, amplifiers, and talk-to-text software that aid in communication
• Change how you communicate with others, such as through face-to-face conversations and lowering background noise
• Build up your chest muscles for better breath control and lung volume

Lifestyle changes

Along with medical treatment, you can also try these changes in your day-to-day life:^2,5

• Speak slowly and use short sentences
• Avoid important conversations when you are overtired
• Rely more on facial expressions and gestures
• Instead of talking on the phone, send emails, texts, or notes
• Use drawings and diagrams during conversations
• Make sure the person you are talking to comprehends what you are saying