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Dysphonia due to Muscle Weakness


Presentation

  • See clinical problems as they present in practice with 3,200 images - many new to this edition. Consult the complete contents of this encyclopedic reference online, with video clips of key index cases![books.google.de]
  • Here, we present a patient with post-polio syndrome who presents with an unusual symptom manifestation of hoarseness.[openaccessjournals.com]
  • To the physical exam and otorhinolaryngological presented diversion of oral rhymes to the right.[arquivosdeorl.org.br]
  • Patients usually present with severe neonatal hypotonia. When respiratory distress is present, death can occur in the first year of life. There is delay of motor milestones during childhood.[nature.com]
Chronic Infection
  • Chronic infection of the tonsils or adenoids can also affect nearby structures such as the eustachian tubes, which is the passage between the back of the nose and the inside of the ear.[beautybydrkay.com]
  • infection by the virus (13).[arquivosdeorl.org.br]
Amyloidosis
  • Sarcoidosis and amyloidosis are also uncommon causes of hoarseness.[aafp.org]
  • - (Chronic: smoking, GERD , LPR ) Neoplasm (Premalignant: dysplasia) - (Malignant: Squamous cell carcinoma) Trauma (Iatrogenic: surgery, intubation) - (Accidental: blunt, penetrating, thermal) Endocrine (Hypothyroidism, hypogonadism) Haematological (Amyloidosis[en.wikipedia.org]
Relapsing Polychondritis
  • Amyloid Wegeners Relapsing Polychondritis Laryngeal trauma (vid infra) The treatment of the above involves full assessment in the Voice Laboratory, voice therapy and surgery depending on the diagnosis.[stvincentsent.com.au]
Fishing
  • THAP1 models are limited to cell cycle pathways in humans, fish, and nematodes, and appear to be critical regulators of cell proliferation and cell cycle progression ( Bessière et al., 2008 ).[jneurosci.org]
Malingering
  • […] unknown etiology that results in uncontrolled contraction of the laryngeal muscles and causes focal laryngeal spasm. 13 Psychogenic voice disorders generally occur as a reaction to stress or as a manifestation of other psychiatric disorders, including malingering[aafp.org]
Sneezing
  • […] arthritis, URI Palpable lymph nodes Carcinoma, URI Professional voice user or untrained singer Vocal abuse Recent head, neck, or chest surgery Vagus or recurrent laryngeal nerve injury Recent intubation or laryngeal procedure Direct trauma Rhinorrhea, sneezing[aafp.org]
Tinnitus
  • Topics covered in MITECD include cochlear implants for children and adults, pitch perception, tinnitus, alaryngeal voice and speech rehabilitation, neural mechanisms of vocalization, holistic voice therapy techniques, computer-based approaches to children's[books.google.de]
Speech Disorders
  • A major new reference work with entries covering the entire field of communication and speech disorders.[books.google.de]
  • Speech Disorders Apraxia Apraxia of speech, also known as Verbal Apraxia or Dyspraxia, is a motor speech disorder caused by damage to the areas of the brain that control speaking.[adultstopediatrics.com]
  • A speech disorder resulting in impaired utterance of sounds by the vocal folds. An unnaturally deep or rough quality of voice. Any speech disorder involving problems of voice quality, pitch, or intensity.[icd10data.com]
  • Disorder: Malfunction of the tongue and/or lip muscles resulting in garbled words or parts or words.[voicefoundation.org]
  • He also writes professional articles on various speech disorders and state of the art treatments on Google’s new Encyclopedia, Helium and AC writers websites. Gal participated on Community Focus radio monthly shows with Dr.[blog.asha.org]
Aphasia
  • […] tinnitus, alaryngeal voice and speech rehabilitation, neural mechanisms of vocalization, holistic voice therapy techniques, computer-based approaches to children's speech and language disorders, neurogenic mutism, regional dialect, agrammatism, global aphasia[books.google.de]
  • Back to top Language Disorders Aphasia Aphasia is a disorder that results from damage to the language parts of the brain. It may cause problems with speaking, listening, reading and writing.[adultstopediatrics.com]
  • […] domain Other ALS: Increased burden of TIA1 low-complexity domain mutations in ALS patients vs controls 2% of familial ALS Allelic disorder: Welander distal myopathy TIA1 protein Clinical Onset ages: 28 to 73 years; Mean 59 years Weakness Bulbar Limb Aphasia[neuromuscular.wustl.edu]
  • Although dysphonia must be differentiated from pure dysarthria, aphasia, or dyspraxia, phonatory dysfunction (frequently resulting from presbylarynx) is very common as a comorbid condition in patients with dysarthria.[emedicine.medscape.com]
Neurologic Manifestation
  • Neurological manifestations of the post-polio syndrome. Crit Rev Clin Neurobiol. 1987, 3:199-220. 14. Ivanyi B, Phoa SS, de Visser M. Dysphagia in postpolio patients: a videoflurographic follow-up study. Dysphagia. 1994, 9:96-8. 15.[arquivosdeorl.org.br]
Scanning Speech
  • speech and dysarthria Multiple sclerosis Soft (loss of volume) Vocal cord paralysis, Parkinson disease Spoken voice lost, but whispered voice maintained Conversion aphonia Strained, effortful phonation Muscle tension dysphonia Strained Laryngopharyngeal[aafp.org]

Workup

  • After complete workup, its frequency fell to 14%.[nature.com]

Treatment

  • There are three main type of treatments: medical treatments, voice therapy and surgical treatments. [25] When necessary, certain voice disorders use a combination of treatment approaches [8] A medical treatment involves the use of botulinum toxin (botox[en.wikipedia.org]
  • Current treatments only help reduce the symptoms. SLP- Voice therapy may reduce some symptoms, especially in mild cases.[blog.asha.org]
  • Speech therapy is also an important part of treatment of spasmodic dysphonia.[entcolumbia.org]
  • Since that first referral from the SLP, treatment has been provided to dozens of patients.[physiotherapy.ca]
  • Incompetent Larynx: Treatment for incomplete vocal fold closure may involve specialized speech therapy and/or surgical management.[texasvoicecenter.com]

Prognosis

  • Back to top What is the prognosis for someone with myositis? In dermatomyositis, most cases and symptoms respond very well to therapy.[kaleidoscopefightinglupus.org]
  • How is MG treated and what is the prognosis? MG is treated with medications called anticholinesterases (pyridostigmine or Mestinon), which restore muscle strength and reduce the tendency toward fatigue.[voicefoundation.org]
  • Prognosis In patients with significant dysphonia 6-12 months after the onset of symptoms, the prognosis for spontaneous recovery is poor.[emedicine.medscape.com]
  • It is not intended to provide instruction and you should not rely on this information to determine diagnosis, prognosis or a course of treatment. It should not be used in place of a professional consultation with a doctor.[dystonia.org.uk]
  • Kurisaki H Prognosis of multiple system atrophy: survival time with or without tracheostomy [in Japanese]. Rinsho Shinkeigaku 1999;39 (5) 503- 507 PubMed Google Scholar 40.[jamanetwork.com]

Etiology

  • Ask the patient to describe the change in voice quality as specifically as possible, because vocal quality may suggest specific etiologies ( Table 3 ).[aafp.org]
  • Practically all categories in the chapter could be designated 'not otherwise specified', 'unknown etiology' or 'transient'.[icd10data.com]
  • Voice disorders can have several different etiologies: functional, organic or neurological.[adultstopediatrics.com]
  • The treatment entails preventing other complications such as aspiration, and addressing the etiology more specifically.[nature.com]
  • In this condition, there is an excessive activity of unknown etiology in one (rarely both) of the sternocleidomastoids. This results in an obvious deviation of head position.[dartmouth.edu]

Epidemiology

  • : 3 Dutch families Gowers (Laing; Early adult onset distal myopathy type III; MPD1) 3, 4 Myosin heavy chain 7 (MYH7) ; Chromosome 14q11.2; Dominant or Sporadic Epidemiology Australian, German, Italian & Austrian families Genetics: MYH7 mutations Types[neuromuscular.wustl.edu]
  • In a epidemiological study performed at Mayo Clinic, was observed that 25% of the patients that survive poliomyelitis presented late effects of the disease (9). Other studies point to a 90% rate (10,11).[arquivosdeorl.org.br]
  • Epidemiological Studies A limited number of epidemiological studies have been published.[karger.com]
  • Epidemiology and inheritance of oculopharyngeal muscular dystrophy in Israel. Neuromuscul Disord 7 Suppl 1 , S38-40. Brais, B. (2009). Oculopharyngeal muscular dystrophy: a polyalanine myopathy. Curr Neurol Neurosci Rep 9 , 76-82.[webeye.ophth.uiowa.edu]
  • Epidemiology A retrospective analysis of data from a large American claims database found that of almost 55 million individuals, 536,943 patients (ages 0 to 65 years) were given a dysphonia diagnosis (point prevalence rate of 0.98%). [ 3 ] One study screening[patient.info]
Sex distribution
Age distribution

Pathophysiology

  • First, onset is gradual after which the disorder becomes chronic, suggesting some adaptation processes are involved in the development of the pathophysiology.[jneurosci.org]
  • Pathophysiological differences between musician’s dystonia and writer’scramp. Brain 2005;128:918–931. doi: 10.1093/brain/awh402 . 60. Quartarone A, Bagnato S, Rizzo V, et al.[tremorjournal.org]
  • Pathophysiology and Treatment of Muscle Tension Dysphonia: A review of Current Knowledge. Journal of Voice, 25(2), 202-207. 3. Tomilson, C., Archer, K. (2014).[physiotherapy.ca]
  • A prospective cohort study with clinical, laryngoscopic, and electromyographic evaluation of patients with ALS is required to provide insight into the epidemiology, pathophysiology, and prognosis of vocal cord dysfunction in ALS.[jamanetwork.com]
  • "Pathophysiology and treatment of muscle tension dysphonia: a review of the current knowledge". Journal of Voice . 25 (2): 202–7. doi : 10.1016/j.jvoice.2009.10.009 . PMID 20400263 . Feierabend RH, Shahram MN (August 2009). "Hoarseness in adults".[en.wikipedia.org]

Prevention

  • Unilateral vocal fold paralysis can be caused by a variety of diseases or disorders that prevent movement in one vocal fold.[texasvoicecenter.com]
  • Note that both vocal cords have a curve to them which prevent a tight closure resulting in air escape. Normal vocal cords are straight and come together tightly to prevent any air escape.[fauquierent.net]
  • Direct prevention describes efforts to reduce conditions that may serve to increase vocal strain (such as patient education, relaxation strategies, etc.), while indirect prevention strategies refer to changes in the underlying physiological mechanism[en.wikipedia.org]
  • What can be done to prevent diseases of the larynx? Quitting smoking and cutting back on drinking alcohol can help prevent laryngeal cancer.[my.clevelandclinic.org]
  • Dermatomyositis cannot be prevented.[healthcommunities.com]

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