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Voice and Swallowing Impact from Neurologic Disorders

Voice and Swallowing Impact from Neurologic Disorders

What impact do neurologic disorders have on voice and swallowing function?

A number of neurologic disorders can cause changes in voice and/or swallowing function. Often, patients already have a diagnosis from a neurologist and are referred to a laryngologist to be evaluated for interventions that can help with their voice or swallowing. Occasionally, a voice or swallowing problem can be the first or only symptom of a neurologic condition.

Common neurologic disorders affecting voice include:

Spasmodic Dysphonia – This disorder primarily affects the voice and not swallowing function. It is caused by abnormal firing of different muscles that move the vocal cords during speech. It gives patients either a strained or breathy voice, depending on which muscles are dominantly affected, and greatly affects the patient’s ability to communicate with others. Patients often report that their voice is worse when speaking on the telephone and more normal when laughing or singing.

Tremor – Tremor of the throat or vocal cords can cause changes that make the voice sound “shaky” or unsteady, and it may overlap with the diagnosis of spasmodic dysphonia. It may occur in the throat or vocal cords alone but often is part of a systemic tremor that affects the neck, hands, arms, or legs.

Parkinson’s Disease – This neurologic disease is characterized by tremor and muscle slowness, both of which can effect voice and swallowing. Many patients notice that their voice becomes weak and tremulous.  Patients may experience an inability to project and be heard easily by others.

Stroke – Changes following a stroke range from minor problems with articulation all the way to profound voice and swallowing changes (including vocal cord immobility) depending on the areas of the brain and brainstem that were affected.

More rare neurologic disorders that can dramatically affect voice and swallowing:

  • Multiple System Atrophy (MSA)

  • Progressive motor neuron diseases

  • Amyotrophic Lateral Sclerosis (ALS)

Voice and Swallowing Impact from Neurologic Disorders Treatment

If your symptoms are mainly voice related, your treatment team will discuss and recommend treatments aimed at improving your vocal quality, projection, and effort required to speak. Examples of available treatments include:

  • Spasmodic dysphonia and tremor (when appropriate) can be treated in office with botulinum toxin to chemically weaken the muscles that are abnormally firing. Our experts often use specialized EMG equipment to perform these vocal cord injections.

  • When appropriate, vocal fold atrophy or vocal cord immobility can be treated with in-office vocal fold injections designed to help the vocal cords come together better. This can also help make swallowing safer.

  • Lee Silverman Voice Treatment is an evidence based voice therapy program for Parkinson’s disease.

If your problems are mainly swallowing related, your treatment team will discuss with you the treatments options available.

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