Neurologic Disorders of the Larynx

Question 1

6 important points to remember

Answer 1

1. Neurologic diagnosis- physician judgment based on observation (symptoms)
2. Examination- multiple laryngeal tasks
3. Assess- gold standard is endoscopy
4. Neurologic disease- usually systemic disease
5. EMG and sensory testing are non-specific tests
6. Psychogenic
7. Team care

Question 2

3 kinds of Diagnosis

Answer 2

Hypokinetic
Hyperkinetic
Mixed Disorders

Question 3

Hypokinetic

Answer 3

1. Paralysis/Paresis
2. Neuromuscular joint disorders
3. Myopathic diseases
4. Progressive neurological disease

Question 4

Hyperkinetic

Answer 4

1. Dystonia
2. Tremor
3. Tic
4. Myclonus
5. Non-neurologic disorders
6. Choreas
7. Psychogenic

Question 5

Mixed Disorders

Answer 5

1. Parkinson’s
2. MS
3. Psychogenic

Question 6

Hypofunctional Voice Characteristics

Answer 6

1. Breathiness
2. Decreased loudness
3. Monopitch
4. Breath at word medial
5. Weak articulation
6. Cognitive issues? (may be helpful to know)

Question 7

Therapies for Hypofunction

Answer 7

i. 100% effort 100% of the time
ii. Breath training
iii. Prosodic awareness
iv. Speech rate training
v. other

Question 8

Hyperfunctional Voice Characteristics

Answer 8

1. Spasms
2. Cessation of phonation
3. Strained, strangled
4. Dyskinesia- unplanned, extraneous movement

Question 9

Therapies for Hyperfunction

Answer 9

a. These are issues where therapy is not effective

b. Treatment is primarily medication