ABSTRACT
The case of a man who initially presented to an emergency room with an isolated dysarthria
is reviewed in order to demonstrate how the history, clinical context, and clinical
observations can lead to accurate or inaccurate diagnosis. The diagnostic process
in this case illustrates (1) the value of experience in clinical practice; (2) the
role of the history and clinical context in diagnosis, but their occasional capacity
to mislead; (3) the importance of distinguishing evidence from inference; (4) the
use of deductive strategies and pattern recognition in speech diagnosis; (5) the importance
of diagnostic vigilance; (6) the value of distinguishing among dysarthria types; and
(7) the contribution that the diagnosis of speech disorders can make to the localization
and diagnosis of neurologic disease.
KEY WORDS
diagnosis - dysarthria - motor speech disorder - myasthenia gravis
