Voice Disorders-neurological

Question 1

What are the 6 ADDuction/abduction neurological disorders

Answer 1

Vocal fold paralysis 
Vocal fold paresis (weakness) 
SLN paralysis 
Pseudo bulbar palsyadductor spasmodic dysphonia 
Huntingtons corea

Question 2

Name the coordination disorder

Answer 2

Adductor Spasmodic dysphonia

Question 3

Name the 3 stability problem disorders

Answer 3

Parkinson’s
ALS
ESSENTIAL tremor

Question 4

What is the most common cause of bilateral VF paralysis?

Answer 4

Surgical trauma

Question 5

If the bilateral lesions happen to the recurrent laryngeal nerve what happens

Answer 5

Affects the PCA so vocal folds will remain Abducted

This causes problems with airway protection

Aphonia is a problem

Question 6

If bilateral lesions happen to CN X WHAT WILL happen?

Answer 6

the LCA, IA, TA will be affected causing the VF to be adducted

Speech will be strained, monotone, low volume

Respiratory will be compromised (wheezing may be heard)

Question 7

What is the most common cause of unilateral paralysis

Answer 7

Lateogenic (surgical injury)

90% unilateral CN X(vagus) nerve damage

Cause flaccidity, decreased tone, dysphagia

Question 8

What is another cause of unilateral paraylsis?

Answer 8

Disease to the recurrent laryngeal nerve (of CN X)

Injury is more common on the left than right (due to open heart surgery)

Question 9

Is causes of unilateral paresis what is expected?

Answer 9

Causes due to trauma caused to the recurrent laryngeal nerve
VF cross midline for ADDuction
Breath is weak, breathy, hoarse, sometimes strained
Bernoulli effect helps with VF closure

Question 10

What is SLN paralysis

Answer 10

Caused by damage during thyroid surgery , can be due to virus
Results in paralysis of the CT muscle
Decreased pitch, intensity ranges, VF closure
Breathiness

Question 11

Why is vocal fold paresis under diagnosised?

Answer 11

Because it is masked by laryngeal muscle tension

Question 12

Presbyohonia

Answer 12

The aging of the voice mechanism
In women, VF get thicker
In men, VF gets thinner

Vocal closure incomplete (bowing)
Yellowing VF

BREATHY, hoarse low pitch voice with tremor

Question 13

Spasmodic dysphonia

Answer 13

Lesion to the basal ganglia

Irregular uncontrollable muscle movements

Question 14

Essential tremor

Answer 14

CNS lesion (likely to the extra pyramidal system)

Symptoms: phonatory instability, Tremor

ALWAYS present in sustained phonation; quiet at rest but present during volition am movement

More common in women

Question 15

Pseudo bulbar palsy

Answer 15

Damage to the corticobulbar pathway
Causes laryngeal muscle weakness , incomplete closure, hyper ADDuction

Symptoms: breathiness, strained, monopitch, harshness

Question 16

Als

Answer 16

Hoarseness, harshness, breathy articulation problems, dysphagia

Ultimately required AAC devices

Question 17

Huntington Chorea-

Answer 17

Caused by basal ganglia lesion (too much movement)
Irregular pitch/sound,
Irregular respiration
Strained/straggled, monopitch, irregular bursts of loudness

Question 18

Parkinson’s

Answer 18

Damage to the basal ganglia (too little movement)
Breathy, weak, decreased loudness, monopitch, hoarse, sometimes tremor

Incomplete
Closure
Can
Sometimes cause compensatory supraglottic squeezing

Question 19

Multiple sclerosis

Answer 19

Impaired loudness, harshness

Question 20

Myasthenia Gravis

Answer 20

Breathy, hypernasality, weak voice, decreased loudness

Question 21

Name the three categories of neurological disorders

Answer 21

ADDuction/abduction problems
Stability problems
Coordination problems