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Speech Problems and Multiple Sclerosis

speech problems and multiple sclerosis

Speech problems affect approximately 40 percent of people who live with multiple sclerosis. These speech challenges can occur routinely or sporatically and be mild to severe, but regardless of their presentation, it’s helpful for individuals with MS to understand what is happening and what they can do about it.


Trouble with speech in multiple sclerosis is highly individual. Some people experience problems during a relapse while others have challenges pop up intermittently several times a day. A critical point for everyone to understand is that speech challenges are not a reflection of an individual’s cognitive or intellectual abilities.

Sometimes, a person’s partner or doctor notices a subtle speech issue even before the patient does. In some cases, speech troubles cause individuals to become embarrassed or to isolate themselves.

Speech problems and multiple sclerosis
Speech function is located in various areas of the brain, including the brainstem. In individuals with multiple sclerosis, lesions can cause numerous difficulties with speech, the most common of which are motor speech disorders, known as dysarthrias.

The type and severity of dysarthria a person can experience depends on which area of the nervous system is affected. Types of dysarthrias include the following:

  • Nasal speech, in which it sounds as if the individual has nasal congestion
  • Scanning dysarthria, in which the normal speech pattern is altered, resulting in long pauses between individual syllables and/or words
  • Slurring, which can occur because the muscles of the tongue, mouth, lips, and/or cheeks are weakened or uncoordinated. This is likely the most common speech challenge in MS patients.
  • Slow speech
  • Distorted vowel sounds and/or trouble varying tone

It is common for individuals with dysarthrias to also experience head shaking, incoordination, or tremor, all of which are associated with lesions located in the brainstem. Swallowing difficulties (dysphagia), including delayed or incomplete swallowing as well as choking, also may accompany dysarthria.

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Dealing with speech problems
Speech and language pathologists (aka, speech therapists) can evaluate and work with individuals to help them improve their enunciation and speech patterns. Some of the assistance these professionals can provide include exercises that can strengthen the muscles of the mouth, tongue, cheeks, and lips, as well as techniques on how to slow down speech and articulate better and breathing control exercises.

For anyone who depends a great deal on speech for their livelihood, such as a teacher or salesperson, such assistance can be especially helpful. But there are other things individuals with MS with speech problems can do. For example:

  • Take your time. Becoming stressed over the situation can only make matters worse.
  • Let a listener know you have a speech challenge
  • Use body language and/or gestures to help you get your point across
  • Because speech problems are more likely to arise when you are fatigued, try to avoid lengthy conversations during those times and/or send an email or text instead
  • If speech problems are especially severe, you can use assistive devices such as texting or programs that translate writing into spoken words

It’s also important to know that problems with talking may be a side effect from medications, especially those that cause dry mouth, so be sure to check with your doctor if you are experiencing speech challenges. Medications can be a cause as well as a contributing factor to speech problems in multiple sclerosis.

Have you experienced speech problems with multiple sclerosis? What advice can you offer on how do you deal with them?

Also read: Hearing problems and multiple sclerosis
Alternative treatments for multiple sclerosis

Multiple Sclerosis Foundation
National Multiple Sclerosis Society