Overview and Facts about Voice Dysfunction in Neurological Disorders
Voice dysfunction is often the result of neurological disorders like Parkinson’s disease, multiple sclerosis, stroke or ALS. These neurological disorders interfere with the control, coordination, and strength of the muscles surrounding the vocal cords.
These conditions can make it hard to swallow, can impact the voice, and may also result in vocal fold paralysis. These neurological conditions interfere with the communication between the nerves, brain and vocal cord muscles, causing them to malfunction.
Symptoms and Signs of Voice Dysfunction in Neurological Disorders
Voice dysfunction in neurological disorders can cause various signs and symptoms, including:
- A change in voice
- Difficulty forming words (dysarthria)
- Malfunction of the lip muscles or tongue
- Garbled words or sounds
- Weak or tired voice
- Partial or full vocal fold paralysis
Tests and Diagnosis of Voice Dysfunction in Neurological Disorders
An otolaryngology specialist, which is a doctor who specializes in the ears, nose, and throat (ENT), diagnoses vocal dysfunction through a physical examination of the throat and vocal cords and a review of medical history and symptoms.
Depending on the symptoms, the doctor may use testing to determine the extent of the damage. Some of the tests your doctor may use include:
- Flexible Laryngoscopy: A flexible scope is inserted through the nose to look at the throat, pharynx and larynx. This study gives basic information regarding the form and function of the throat structures.
- Videostroboscopy: A flexible scope with a camera is inserted through the nose and fed into the larynx to visualize the vocal cords. A strobe light makes the vocal cords appear in slow motion and the examination is recorded. This study diagnoses and evaluates in detail the anatomy, physiology and any pathology of the vocal cords.
- Laryngeal Electromyography: Small needles are inserted through the skin in the neck into selected muscles of the throat and larynx in order to determine the neurologic status of those muscles. This test can help assess and predict the functioning of a given muscle.
- Acoustic Analysis: Computer evaluation of multiple features of your voice assists in the diagnosis and treatment of your voice disorder. These measurements also serve as a way to objectively evaluate the progress that is made during and after treatments.
Causes and Risk Factors of Voice Dysfunction in Neurological Disorders
A variety of neurological disorders can cause voice dysfunction by impacting how the nerves and muscles surrounding the vocal cords communicate.
Some of the most common neurological disorders that affect the voice are the following:
Voice dysfunction in neurological disorders can happen to anyone, but risk factors have not yet been identified.
Treatment and Care for Voice Dysfunction in Neurological Disorders
The course of treatment the doctor decides on depends on the severity and type of symptoms the patient experiences, as well as the neurological disorder that’s impacting the vocal folds. Although most neurological diseases don’t have a cure, their symptoms may be reduced.
Some of the most common interventions to improve the voice include:
- Voice Therapy: This patient-centered treatment method attempts to modify behaviors and vocal techniques that contribute to abnormal voicing. Voice exercises will vary depending on the specific pathology being treated. Treatments are generally four to six sessions weekly.
- Botulinum Toxin: Injections of this substance into specific muscles can be used to treat neurologic disorders such as spasmodic dysphonia, tremors of the vocal cords and other abnormal spasming in the head and neck region. These injections need to be repeated every three to six months.
- Fillers: Fat, gels or calcium composites can be injected into a weak or paralyzed vocal cord either through the mouth or through the skin of the neck in order to add bulk. By doing so, it pushes the vocal cords closer together allowing them to vibrate and produce an improved voice.
- Thyroplasty: A small incision is made in the neck and a window is created into the larynx. Under mild sedation, an implant is inserted to push the weak or paralyzed vocal cord closer to the opposite vocal cord to improve voice permanently.
Your doctor may also recommend rest, quitting smoking or the removal of any lesions.
