Neurological Voice Disorders:
Voice problems caused by abnormal control, coordination, or strength of voice box muscles due to an underlying neurological disease such as: stroke, Parkinson’s disease, multiple sclerosis, myasthenia gravis, or ALS
Difficulty forming words – presenting with imprecise consonants and hard-to-understand speech as seen with stroke patients
Malfunction of the tongue and/or lip muscles resulting in garbled words or parts or words.
What are the typical symptoms of voice dysfunction in patients with multiple sclerosis (MS)?
- MS is a chronic neurological disease characterized by episodes of dysfunction of the nervous system that increase and decrease (remit and recur) over several decades. Commonly, long periods of normal function occur in between these episodes.
- Voice symptoms may include hoarseness and poor control of volume and pitch.
- Speech problems are more common and have been characterized as “scanning speech,” in which each syllable is produced slowly and hesitantly with a pause after every syllable.
- Other important symptoms of MS include dizziness (vertigo) and altered vision.
What is the cause of MS? Who is at risk?
The cause of MS is unknown, but it is thought to be viral in origin. The process involves loss of the protective sheath around nerves in the brain/brainstem. The disease is more common in females, higher socioeconomic groups, and at northern and southern latitudes (more rare at the equator). Onset of disease most frequently occurs in young adulthood.
How is MS diagnosed?
Diagnosis of MS may take years. MS is characterized by multiple signs and symptoms, with remissions and exacerbations of the disease. CT or MRI scans may show the characteristic scar changes in the brain, and fluid from spinal tap may also help in the diagnosis.
Difficulties in Diagnosis
Because of the long latent periods (periods where disease is not present) and the waxing and waning of symptoms, MS is easily missed. Repeated examinations and clinical suspicion by a neurologist will help make the diagnosis.
How is MS treated and what is the prognosis?
- There is no cure for MS at this time. Care is directed towards controlling symptoms.
- Speech therapy plays an important role in improving quality of life in patients.
- Medical therapy includes corticosteroids for acute exacerbations of MS symptoms.
- For chronic treatment of MS, interferon and chemotherapeutics such as Novantrone have been used to slow the progression of the disease.
Patient education material presented here does not substitute for medical consultation or examination, nor is this material intended to provide advice on the medical treatment appropriate to any specific circumstances.
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