Sinusitis

Paresis of the soft palate, after adenotomies and tonsillectomies for the treatment of paresis. Progressive bulbar palsy Causes of soft palate paralysis

How to distinguish paresis (paralysis) of the soft palate from functional nasality?

It is important to distinguish paresis (paralysis) of the soft palate from functional (habitual) nasality. You can do this in the following ways:

The child opens his mouth wide. Speech therapist (parent) presses with a spatula (the handle of a spoon) on the root of the tongue. If the soft palate reflexively rises to the back wall of the pharynx, we can talk about functional nasality, but if the palate remains motionless, there is no doubt that the nasality is of organic origin (paresis or paralysis of the soft palate).

The child lies on his back and says some phrase in this position. If the nasal sound disappears, then we can assume paresis (paralysis) of the soft palate (the nasal sound disappears due to the fact that when lying on the back, the soft palate passively falls to the back wall of the pharynx).

First of all, you will need to activate the soft palate and make it move. For this you will need special massage . If the child is too small, adults do the massage:

1) with a clean, alcohol-treated index finger (pad) of the right hand, in the transverse direction, stroking and rubbing the mucous membrane at the border of the hard and soft palate (in this case, a reflex contraction of the muscles of the pharynx and soft palate occurs);

2) the same movements are made when the child pronounces the sound “a”;

3) make zigzag movements along the border of the hard and soft palate from left to right and in the opposite direction (several times);

4) with your index finger, perform a point and jerk massage of the soft palate near the border with the hard palate.

If the child is already big enough, then he can do all these massage techniques himself: the tip of the tongue will cope with this task perfectly. It is important to correctly show how all this is done. Therefore, you will need a mirror and the interested participation of an adult. First, the child performs massage with the tongue with his mouth wide open, and then, when there are no more problems with self-massage, he will be able to perform it with his mouth closed, and completely unnoticed by others. This is very important, because the more often the massage is performed, the sooner the result will appear.

When performing a massage, you must remember that you can cause a gag reflex in a child, so do not massage immediately after eating: there should be at least an hour break between meals and massage. Be extremely careful and avoid rough touches. Do not massage if you have long nails: they can damage the delicate mucous membrane of the palate.

In addition to massage, the soft palate will also need special gymnastics. Here are some exercises:

1) the child is given a glass of warm boiled water and asked to drink it in small sips;

2) the child gargles with warm boiled water in small portions;

3) exaggerated coughing with the mouth wide open: at least 2-3 coughs on one exhalation;

4) yawning and imitation of yawning with the mouth wide open;

5) pronouncing vowel sounds: “a”, “u”, “o”, “e”, “i”, “s” energetically and somewhat exaggerated, on the so-called “hard attack”.

Restoring breathing

First of all, it is necessary to eliminate the causes: carry out appropriate operations, get rid of adenoids, polyps, fibroids, deviated nasal septum, inflammatory swelling of the nasal mucosa with a runny nose and allergic rhinitis, and only then restore proper physiological and speech breathing.

It can be difficult, and sometimes even uninteresting, for a small child to perform exercises just for demonstration. Therefore, use gaming techniques, come up with fairy-tale stories, for example these:

“Ventilating the cave”

The tongue lives in a cave. Like any room, it must be ventilated frequently, because the air to breathe must be clean! There are several ways to ventilate:

Inhale air through your nose and exhale slowly through your wide open mouth (and so on at least 5 times);

Inhale through the mouth and exhale slowly through an open mouth (at least 5 times);

Inhale and exhale through your nose (at least 5 times);

Inhale through your nose, exhale through your mouth (at least 5 times).

"Blizzard"

An adult ties pieces of cotton wool onto strings and fastens the free ends of the threads onto his fingers, thus making five strings with cotton balls at the ends. The hand is held at the level of the child’s face at a distance of 20–30 centimeters. The baby blows on the balls, they spin and deviate. The more these impromptu snowflakes spin, the better.

"Wind"

This is done in the same way as the previous exercise, but instead of threads with cotton wool, a sheet of paper is used, cut with a fringe at the bottom (remember, such paper was once attached to the windows to repel flies?). The child blows on the fringe, it deviates. The more horizontal the strips of paper take, the better.

"Ball"

Tongue's favorite toy is a ball. It's so big and round! He's so much fun to play with! (The child “puffs up” his cheeks as much as possible. Make sure that both cheeks puff out evenly!)

“The ball deflated!”

After prolonged games, the tongue's ball loses its roundness: air comes out of it. (The child first strongly inflates his cheeks, and then slowly exhales air through his rounded and elongated lips.)

"Pump"

The ball has to be inflated using a pump. (The child’s hands perform the corresponding movements. At the same time, he himself pronounces the sound “s-s-s-..." often and abruptly: the lips are stretched in a smile, the teeth are almost clenched, and the tip of the tongue rests against the base of the lower front teeth. The air comes out of the mouth strongly pushes).

"The tongue plays football."

Tongue loves to play football. He especially likes scoring goals from the penalty spot. (Place two cubes on the side of the table opposite from the child. This is an improvised goal. Place a piece of cotton wool on the table in front of the child. The baby “scores goals” by blowing from a wide tongue inserted between his lips onto a cotton swab, trying to “bring” it to the goal and get into them. Make sure that your cheeks do not swell and the air trickles down the middle of your tongue.)

When performing this exercise, you need to make sure that the child does not accidentally inhale the cotton wool and choke.

"The tongue plays the pipe"

Tongue also knows how to play the pipe. The melody is almost inaudible, but a strong stream of air is felt, which escapes from the hole of the pipe. (The child rolls a tube from his tongue and blows into it. The child checks the presence of a stream of air on his palm).

"Block and Key"

Does your child know the fairy tale “Three Fat Men”? If so, then he probably remembers how the girl gymnast Suok played a wonderful melody on the key. The child tries to repeat this. (An adult shows how to whistle into a hollow key).

If you don’t have a key at hand, you can use a clean, empty bottle (pharmacy or perfume) with a narrow neck. When working with glass vials, you must be extremely careful: the edges of the bubble should not be chipped or sharp. And one more thing: watch carefully so that the child does not accidentally break the bottle and get hurt.

As breathing exercises, you can also use playing children's musical wind instruments: pipe, harmonica, bugle, trumpet. And also inflating balloons, rubber toys, balls.

All of the above breathing exercises should only be performed in the presence of adults! Remember that when doing exercises, your child may become dizzy, so carefully monitor his condition, and stop the activity at the slightest sign of fatigue.

Articulation exercises for rhinolalia

For open and closed rhinolalia, it can be very useful to perform articulation exercises for the tongue, lips and cheeks. You can find some of these exercises on the pages of our website in the sections “Classical articulation gymnastics”, “Fairy tales from the life of Tongue”.

Here are a few more. They are designed to activate the tip of the tongue:

1) “Liana”: hang your long, narrow tongue down toward your chin and hold in this position for at least 5 seconds (repeat the exercise several times).

2) “Boa constrictor”: slowly stick your long and narrow tongue out of your mouth (do the exercise several times).

3) “Boa Tongue”: with a long and narrow tongue, sticking out as much as possible from the mouth, make several quick oscillatory movements from side to side (from one corner of the mouth to the other).

4) “Watch”: the mouth is wide open, the narrow tongue makes circular movements, like the hand of a clock, touching the lips (first in one direction and then in the other direction).

5) "Pendulum": the mouth is open, a narrow long tongue is protruding from the mouth, and moves from side to side (from one corner of the mouth to the other) counting “one - two”.

6) “Swing”: the mouth is open, the long narrow tongue either rises up to the nose, then falls down to the chin, counting “one or two.”

7) "Injection": a narrow, long tongue presses from the inside first on one cheek, then on the other.

You can also diversify articulation gymnastics

GASTRONOMIC AND Speech Therapy GAMES

Fun articulation exercises for children that they will have great fun doing because all the exercises are done with sweets!

According to the literature, the share of tonsillectomies among other otorhinolaryngological interventions is 20-75%, and adenotomies 6.5-40.9%. Despite this, in the extensively studied literature we find relatively few works that comprehensively cover the topic we have raised.

Transient and persistent paresis of cranial nerves - at the level of nuclei, fibers, nerve endings - including those innervating the soft palate, are considered rare complications in the literature.

Paresis of the soft palate is clinically characterized by a violation of its important functions with the development of dysphagia, accompanied by the flow of liquid food into the cavity of the nasopharynx and nose. Speech takes on a nasal, nasal tone because the sound resonates in the nasopharynx, which is not covered by the velum palatine. A unilateral lesion is manifested by drooping of the soft palate on the affected side, immobility or lagging behind on this side during phonation. The tongue deviates to the healthy side. The pharyngeal and palatal reflexes are reduced or lost on the affected side. Damage to sensitive fibers leads to anesthesia of the mucous membrane of the soft palate and pharynx.

In the genesis of paresis of the soft palate after adenotomies and tonsillectomies, a number of factors are important: impregnation with an anesthetic substance or direct injury to the nerve with a needle during anesthesia; blockade or damage to the nerve with a needle during deep injections or rough manipulations; paresis that goes away within a few hours is caused by a nerve block, long-term or persistent – due to mechanical damage. The possibility of such damage is associated with the anatomical proximity of the tonsils to the parapharyngeal space, in the posterior sections of which the glossopharyngeal, vagus, accessory, hypoglossal cranial nerves and the borderline sympathetic trunk pass, and in the retropharyngeal space - the facial one. Direct injury to the nerve by the instrument or compression of the nerve by hematoma, wound discharge and edematous tissue is possible, with subsequent involvement of the nerves in the scarring process. Damage (wound) to the anatomical formations adjacent to the nasal part of the pharynx can lead to paresis of the soft palate, since the muscles and their tendons involved in its movement are injured. Paresis of the soft palate can also be caused by damage to the cranial nerves innervating the soft palate at the level of their nuclei, such as bulbar syndrome, as a result of infection entering the medulla oblongata from the nasopharynx hematogenously or through the perineural spaces, or decompensation of organic pathology of the brain such as tonsillogenic vasculitis .

We treated 9 children with paresis of the soft palate after operations on the lymphoid-pharyngeal ring (after adenotomy - 7, after tonsillectomy - 2). The treatment complex included means that provided improvement or restoration of metabolic processes and regeneration of nervous tissue:

Vitamins of group B1, B6, B12, A, E, or complex preparations - milgama, neuromultivit; cocarboxylase, ATP

Biogenic simulators: aloe extract, PHYBS, humizol, apilak

Vasodilators: nicotinic acid, dibazole

Agents that improve vascular microcirculation: Trental, Cavinton, Stugeron

Agents that improve the conductivity of nervous tissue: proserin, galantamine

Antihistamines and hyposensitizing drugs

Agents that normalize the functional state of the nervous system - glycine, novo-passit.

These groups of drugs are used in combination with physiotherapy (endonasal electrophoresis with dalargin, galvanization with novocaine in the submandibular area, bioelectric stimulation of paralyzed muscles, neck massage).

In 6 children, it was possible to restore the function of the soft palate; treatment for three children continues.

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Soft palate paralysis

Palate paralysis is weakness and/or atrophy of the muscles of the tongue, larynx and soft palate.

Causes and course of the disease. The causes of paralysis of the soft palate can be injuries (including medical post-operative), the occurrence of tumors that compress nerves, hematomas, aneurysms, pathologies of the thyroid gland and the result of their treatment, neuritis, etc. With the development of paralysis of the soft palate, the tongue becomes soft and inactive, the swallowing process is disrupted, speech becomes difficult and nasal, and liquid food can flow into the nasopharynx. In this case, hoarseness and hearing impairment, shortness of breath and difficulty breathing may occur.

Paralysis can be unilateral or bilateral. Unilateral paralysis is characterized by sagging of the soft palate on one side, the uvula becomes soft and deviates towards the healthy half. Bilateral paralysis affects both sides and is characterized by increased symptoms.

Diagnosis and treatment. The diagnosis is made based on the clinical picture and examination of the patient. With paralysis of the soft palate, the patient is unable to puff out his cheeks. Treatment depends on the severity and duration of the disease. First, the cause that caused the paralysis of the soft palate is eliminated. For example, inflammatory paralysis is treated with drugs that help with laryngitis. It is possible to prescribe rest (silence) to restore functions or a set of measures that increase the tone of the larynx. Traumatic paralysis can be treated with absorbable agents that relieve swelling. If the paralysis is persistent, then surgical intervention may be indicated. In any case, the prescription of treatment and all procedures must be carried out by an ENT doctor.

Treatment of vocal cord paresis

Laryngeal paresis (paralysis) is a decrease in muscle strength in the area of the respiratory system that connects the pharynx to the trachea, containing the vocal apparatus. Characterized by damage to the motor pathway of the nervous system.

The vocal apparatus is an expansion and contraction of the gap located in the larynx between the vocal cords, through which air passes to produce sounds, and the level of tension of the vocal cords depends on the activity of the muscles of the larynx due to nerve impulses. If part of this system is damaged, laryngeal paresis occurs.

This disease is characterized by a decrease in the ability to perform actions related to the activity of the larynx, such as breathing and producing sounds.

Considering that paralysis of the larynx is caused by quite common causes, it occupies one of the leading places among ENT diseases (ear, nose, throat).

Causes of the disease

Paralysis is provoked by a fairly diverse number of causes and affects people regardless of age and gender. Often formed as a result of other diseases.

thyroid diseases;
tumors of the larynx, trachea, cervical spine and their metastases;
previous strokes;
various inflammations of the serous membrane of the lungs;
peripheral nerve disease as a consequence of previous intoxications, infectious diseases (tuberculosis, botulism, ARVI, etc.), poisoning;
hematoma formation due to mechanical damage to the neck;
accumulation in the tissues of the body of elements mixed with blood and lymph during infectious inflammation of the larynx;
protrusion of the wall of an artery or vein caused by its stretching;
immobility of the arytenoid cartilage;
diseases of the brain and spinal cord, as well as the spine;
postoperative injuries to the cervical region, head, chest (paralysis of the vocal cords, as a consequence of the operation, is characteristic in most cases of incorrect surgical intervention);
harmful effects of chemotherapy drugs.

Paresis of the larynx often occurs in people whose work involves a high load on the vocal apparatus.

Paresis of the vocal cords is also observed in people, the causes of which were severe stress, smoking, harmful production conditions associated with the exhalation of harmful and toxic substances, as well as cold, smoky air and mental illness.

Types, symptoms, consequences

Interestingly, paralysis of the larynx and paresis of the palate (part of the soft palate that separates the oral cavity from the pharynx) have the same clinical picture.

Symptoms depend on the duration of the disease and the nature of the inflammation of the larynx.

Paralysis occurs: unilateral, bilateral. If there is a second one, sick leave is provided. Unilateral paresis is characterized by inflammation of half of the larynx, the left or right fold. With unilateral paresis, the signs of the disease are less pronounced and may develop disruption of the lungs and bronchi.

Considering that bilateral paralysis, as well as paresis of the soft palate, have symptoms associated with impaired breathing, they can cause asphyxia and, as a consequence, death, as well as severe changes in the voice, including its complete loss.

The following symptoms most characterize laryngeal paresis:

hoarseness, change in voice;
conversation in a whisper;
rapid fatigue of the vocal cord;
difficulty swallowing;
pain in the neck;
disturbances in the motor activity of the tongue and soft palate;
shortness of breath, slow pulse;
sensation of a lump or foreign object in the throat;
cough;
headache, irregular sleep, weakness, increased anxiety (with paralysis provoked by stressful situations, mental disorders);
blueness above the upper lip;
choking;
respiratory failure (typical of bilateral paralysis and requires urgent treatment).

The main external signs of inflammation of the vocal cords are disturbances in the functions of speech and breathing.

In addition to the nature of the disease (unilateral, bilateral), laryngeal paresis is divided into types, also often depending on its nature: myopic, neuropathic, functional.

Myopic, characteristic of bilateral paresis with impaired speech and breathing functions, up to asphyxia.

Neuropathic, in most cases, occurs unilaterally, associated with the formation of weakening muscles that widen the gap, gradually turning into the muscles of the larynx. Restoration of phonation occurs after a long time. With bilateral neuropathic paresis of the larynx, asphyxia may occur.

Functional is typical for people who have experienced stressful situations or viral diseases. The uniqueness of this type lies in the fact that it is characterized by the sonority of the voice when crying, laughing or coughing. There is a sore throat, pain, and pain in the head, irritability, weakness, sleep disturbance, and mood swings.

Diagnosis and treatment

Taking into account that this is a rather dangerous disease, its timely diagnosis and subsequent treatment are an important factor for the further normal functioning of a person.

Before treating the disease, it is necessary to correctly diagnose it. To establish it, you need to see a doctor and undergo the prescribed examination. It is not recommended to diagnose yourself!

The attending physician, after analyzing the complaints and external examination of the neck and oral cavity, will prescribe one of the following examinations: laryngoscopy, which includes studying the location of the vocal cords, the presence of inflammation, the condition of the laryngeal mucosa and its integrity, tomography, radiography and electromyography, which allows for an assessment of the condition of the muscles. To determine the level of impairment of vocal functions, phonography, stroboscopy, and electroglottography can be used.

The therapy provided directly depends on the causes of the disease, as well as its nature. Its task is to restore the basic functions of the larynx: breathing and sound production.

Drug therapy, surgical intervention, and physiotherapeutic procedures are used, among which phoniatric exercises are common for paresis of the vocal cords.

Most often, for diseases of the larynx, medications are prescribed (taking into account the cause of the disease): decongestants, antibacterial, antiviral, vascular, improving brain function, activating muscle activity, antidepressants, vitamin complex.

Surgical intervention is required in the presence of tumors, thyroid diseases, muscle laxity, and the onset of suffocation.

Physiotherapy includes electrophoresis, magnetotherapy, acupuncture, hydrotherapy, massage, psychotherapy, phonopedia, and gymnastics.

Breathing exercises, including slowly blowing and drawing in air, using a harmonica, puffing out the cheeks and releasing air slowly, taking an extended breath, as well as training the neck muscles, have become of great importance in the rehabilitation and treatment of paralysis of the larynx and soft palate.

Prevention and prognosis

Paresis of the palate and larynx can be avoided. To do this, it is necessary to exclude a possible part of the causes of their occurrence. This is to avoid stressful situations, reboots of the vocal cords, viral diseases, avoid smoking and inhaling stale air if possible. And also to prevent complications of diseases that can cause paresis.

For any disease, maintaining a healthy lifestyle and maintaining immunity have beneficial effects on the body and increase the body's resistance to various inflammatory processes.

Paresis of the larynx is completely treatable, especially if it is unilateral, and subsequently does not have any consequences after the therapy.

In any case, the sooner you start treatment, which must be prescribed by a specialist (only in this case can you hope for its effectiveness), the more positive the prognosis for a complete cure.

This disease has similar symptoms to other diseases, for example, palate paresis, and therefore you need to be able to correctly diagnose the disease in time in order to prescribe the correct treatment.

Since this disease has a fairly wide range of causes, it poses a danger to life and for the normal functioning of the body it must be taken quite seriously, and not delay or neglect the treatment prescribed by a specialist.

The information on the site is provided solely for popular informational purposes, does not claim to be reference or medical accuracy, and is not a guide to action. Do not self-medicate. Consult your healthcare provider.

Paresis of the stomach, soft palate and tongue, diaphragm

Paresis refers to a number of serious neurological disorders, which is partial paralysis - incomplete loss of the ability to move any organ. Can affect any part of the body. Paresis of the stomach is called gastroparesis, and paresis of all extremities is called tetraplegia.

The disease is caused by a disruption in the nerve pathways. The severity is assessed in the system:

0 points means complete plegia (immobility);
1 point corresponds to a condition in which there is contractile activity in the muscles, but it is so low that it is practically unnoticeable;
2 points are given if there are movements in the horizontal plane, there are movements in the joints, but they are constrained;
3 points equals a situation in which the limbs rise, that is, they work not only horizontally;
4 points correspond to full range of motion with reduced muscle strength;
5 points is the norm for a healthy person.

Depending on the type of paresis, it can be divided into:

Lethargic, with pathological relaxation of muscles with a decrease in their tone - hypotonicity;
Spastic, with excessive tension and increased activity - hypertonicity.

Gastric paresis

Gastroparesis is a disorder of the nervous activity of the stomach, which does not allow the organ to empty itself of food under normal conditions. Gastric paresis is associated with damage to the vagus nerve, which is responsible for regulating the digestive system. Its damage causes disruption of normal muscle functioning. Because of this, an obstacle is created in the movement of food through the gastrointestinal tract - gastrointestinal tract.

Conceptually, it is impossible to determine the cause of gastroparesis. However, among the factors stand out:

Uncontrolled diabetes mellitus;
Surgical interventions on the stomach with mechanical damage to the vagus nerve;
Negative drug effects of some antidepressants and stimulants;
Parkinson's disease;
Multiple sclerosis;
Amyloidosis;
Scleroderma.

The main symptoms of gastric paresis consist of:

Feelings of heartburn or the presence of GERD - gastroesophageal reflux disease;
Nausea and vomiting;
Feelings of rapid saturation;
Bloating;
Poor appetite and weight loss;
Uncontrolled blood glucose levels.

Paresis is fraught with adverse consequences for the body. Thus, unable to release food normally, the stomach becomes rigid. The food that accumulates in its cavity stagnates and ferments. This causes an increase in the number of bacteria, and as a result, infectious processes.

Food that stagnates in the body for a long time hardens and becomes beozar, almost stone. An obstruction in the digestive tract can cause further stagnation. Gastric paresis is a chronic, long-term process. The drugs Metoclopramide and Erythromycin can be used to treat it.

If gastroparesis reaches critical proportions, an operation is prescribed, which consists of surgically inserting a special tube. It is introduced through the abdomen into the small intestine so that nutrients can reach the intestines without stagnating in the stomach. So, food is absorbed faster.

Another option is intravenous or parenteral nutrition. The substances enter directly into the bloodstream using a catheter. Electrical stimulation is used for treatment. Its purpose is to connect electrodes, which cause contraction of the stomach walls, due to which food moves into the intestines.

Paresis of the soft palate and tongue

Paresis of the tongue and soft palate causes problems with swallowing and speech. The soft palate is a movable muscular aponeurosis that separates the nasopharynx from the oropharynx through the contraction of its muscles. The nerves approaching the tongue and palate are called the vagus, trigeminal, glossopharyngeal and sublingual. Their defeat causes paresis.

Causes of disruption of the innervation of these organs:

Inflammatory and infectious processes such as polio or diphtheria;
Congenital defects;
Decreased blood supply to the brain in the vertebrobasilar system according to the ischemic type;
Injuries that occur due to household injuries, technical errors during intubation or aspiration, as well as probing or endoscopy;
ARVI;
Tumor neoplasms.

This dangerous disease manifests itself symptomatically:

Disorders of swallowing and breathing;
Violation of speech act;
Problems with ventilation of the auditory tube;
Dysphagia - food begins to flow into the nasopharynx, since the septum holding it back no longer fulfills its function;
Violation of phonation, that is, a change in voice. He becomes nasal;
Problems with pharyngeal and palatal reflexes;
Decreased sensitivity in the mucous membrane, soft palate, tongue;
Violation of the act of chewing.

Diaphragm paresis

Paresis of the diaphragm is also called Cofferat syndrome. It manifests itself as a limitation of functioning caused by damage to the phrenic nerve. This disease occurs mainly during childbirth. And often in children who have spent a long time in conditions of asphyxia.

Such children require very careful handling. Obstetric benefits may not be favorable to them. However, the child will not survive without them. Thus, the most common cause of diaphragm paresis during childbirth is tilting of the upper limb of the fetus. This condition is a consequence of difficulty in removing the baby’s shoulders and head.

In addition to obstetric causes, the nature of paresis may be congenital. A striking example is myotonic dystrophy. Symptoms:

Swelling of the chest on the affected side.
Dyspnea;
Rapid and irregular breathing;
Repeated bouts of cyanosis;

80% of cases involve the right side of the chest. About 10% is a two-way process. Paresis is detected using radiography. On it, the dome of the diaphragm appears as a sedentary formation. Diaphragmatic paresis in a newborn baby contributes to the occurrence of pneumonia.

This disease should be treated by providing active pulmonary ventilation. Up to the full volume of respiratory movements. Therapy is carried out using transcutaneous stimulation of the phrenic nerve. The prognosis of treatment will depend on the extent and severity of the process.

Most sick babies recover within 10 to 12 months. Symptoms of the disease in these cases go away earlier, but treatment should not be stopped until the signs of the disease on X-ray disappear. The bilateral process is rightfully considered the most dangerous. Mortality in these cases reaches 50%.

After a stroke

Stroke is often complicated by paresis. The pathology occurs on the side controlled by the affected part of the brain. Each hemisphere is responsible for controlling the opposite part of the body. Thus, paresis on the right occurs due to an ischemic accident of the left hemisphere. It occurs more often, in 60% of cases.

Pathology on the right side is characterized by a more favorable prognosis than on the left side. Paresis after a stroke is of two types:

Symptoms following a stroke are associated with:

Speech disorders;
Fading of language and verbal memory. Patients forget words and speech patterns, cannot read and write;
Immobility of the limbs on the affected side, while the arm is clenched and pressed against the body, the leg is extended at the knee;
Changes in facial muscles. On the affected side, the corner of the mouth and lower eyelid droop;
Depressed mental state, isolation.

Corrective work for rhinolalia

How to distinguish paresis (paralysis) of the soft palate from functional nasality?

It is important to distinguish paresis (paralysis) of the soft palate from functional (habitual) nasality. You can do this in the following ways:

The child opens his mouth wide. The speech therapist (parent) presses with a spatula (the handle of a spoon) on the root of the tongue. If the soft palate reflexively rises to the back wall of the pharynx, we can talk about functional nasality, but if the palate remains motionless, there is no doubt that the nasality is of organic origin (paresis or paralysis of the soft palate).

First of all, you will need to activate the soft palate and make it move. This will require a special massage. If the child is too small, adults do the massage: