Neurologic Disorders

Amyotrophic Lateral Sclerosis (ALS) or Lou Gehrig’s disease is a debilitating progressive neurologic disease characterized by muscle weakness, atrophy, fasciculations, spasticity, difficulty articulating words, difficulty swallowing, and difficulty breathing. Patients sometimes present initially to the laryngologist with complaints of difficulty speaking or swallowing.   While there is currently no cure for ALS, if a patient choses to use a ventilator to asses with breathing, we will perform a tracheostomy and help to manage the tracheostomy long-term.  Referrals may also be given for swallowing therapy.

Parkinson's disease is a degenerative disorder of the central nervous system with symptoms such as tremor, rigidity and slowness of movement. Parkinson's disease can also affect the voice. The most common voice change in Parkinson's disease is hypophonia or reduced volume of speech.  One treatment option for Parkinson's hypophonia is specialized speech therapy with a technique called Lee Silverman Voice Treatment (LSVT) to help a person regain strength in the voice.  Some patients with Parkinson's disease develop weakness and bowing of both vocal folds.  When this happens a person is left with a very breathy voice due to glottic insufficiency. If this is the cause of hoarseness treatment options may include vocal fold injection augmentation or medialization thyroplasty.

A stroke is the rapid loss of brain function due to loss of blood supply to a portion of the brain.  The symptoms of a stroke depend on the area of the brain that is affected.  If the area that controls the muscles of the throat, tongue or vocal folds area affected, a person may develop voice changes or difficulty swallowing after a stroke.  If the cause of the voice change is dysarthria (difficulty articulating speech), a patient may be treated with speech therapy to help gain strength and coordination of the muscles of the tongue.  If the voice change is from a paralyzed vocal fold, a patient may be given several options of treatment such as [voice therapy], [vocal fold injection augmentation], or [medialization thyroplasty].  Difficulty swallowing after a stroke may be from many different causes.  It is important to first assess the safety of swallowing, discern the cause of the difficulty swallowing, and then initiate treatment which often involves [swallow therapy].