438The hypoglossal nerve is a motor nerve that innervates the musculature of the tongue.

438     The hypoglossal nerve is a motor nerve that innervates the musculature of the tongue.

439     Dysarthia is a situation where the articulation of the voice mechanism is at fault. Pronunciation is unclear, although the linguistic content and meaning are normal.

440     Dysphagia is a condition in which the action of swallowing is difficult to perform, painful, or in which swallowed material is delayed in its passage to the stomach. Speech is slowed or slurred and may be completely unintelligible or non- functional. All other causes of difficulty with chewing or swallowing should be assessed using Table 7.7: Chewing and swallowing (see Chapter 7 – Ear, nose and throat disorders). For the same condition, WPI ratings from Table 7.7 may not be combined with WPI ratings from Table 12.5.6: The glossopharyngeal, vagus, spinal accessory and hypoglossal nerves (IX, X, XI and XII).

Table 12.5.6: The glossopharyngeal, vagus, spinal accessory and hypoglossal nerves (IX, X, XI and XII)

| 10 | Mild dysarthria (speech slow or slurred especially when tired).<br>Dystonia (only neurological).<br>Mild dysphagia (coughing on liquids or semi-solid foods).<br>Diet limited to semi-solid or soft foods.<br>Spasmodic torticollis (only neurological). | | 25 | Moderately severe dysarthia (speech is laboured, imprecise, and often unintelligible).<br>Speaker is required to repeat often and may need augmentative device to help convey message. Moderately severe dysphagia with nasal regurgitation and aspiration of liquids and semisolid foods.<br>Diet limited to liquid foods. | | 50 | Severe dysarthia – speech may be completely unintelligible or non-functional, or intelligible only to familiar people, and only with the aid of an augmentative communication device.<br>Severe dysphagia (inability to swallow food, liquids or manage oral secretions).<br>Regular suctioning required.<br>Ingestion of food requires tube feeding or gastrotomy. |

12.6   Neurological impairment of the respiratory system

441     Where the ability to breathe is impaired because of a neurological impairment, Table 12.6: Neurological impairment of the respiratory system may be used. Impairments of the respiratory system not of documented neurological origin are assessed under Chapter 2 – The respiratory system. They are not assessed under Table 12.6.

Table 12.6: Neurological impairment of the respiratory system

| 10 | Able to breathe spontaneously but has difficulty performing activities of daily living that require moderate exertion. | | 25 | Able to breathe spontaneously but is restricted to sitting, standing or limited walking. | | 60 | Able to breathe spontaneously but to such a limited degree that the employee is confined to bed. | | 90 | No capacity for spontaneous respiration. |