J Korean Soc Laryngol Phoniatr Logoped.  2017 Dec;28(2):71-78. 10.0000/jkslpl.2017.28.2.71.

Differential Diagnosis between Neurogenic and Functional Dysphonia

Affiliations
  • 1Department of Otorhinolaryngology-Head and Neck Surgery, Kangbuk Samsung Hospital, Sungkyunkwan University School of Medicine, Seoul, Korea. entlsh@hanmail.net

Abstract

Voice disorder is classified into three categories, structural, neurogenic and functional dysphonia. Neurogenic dysphonia refers to a disruption in the nerves controlling the larynx. Common examples of this include complete or partial vocal cord paralysis, spasmodic dysphonia. Also it occurs as part of an underlying neurologic condition such as Parkinson's disease, myasthenia gravis, Lou Gehrig's disease or disorder of the central nervous system that causes involuntary movement of the vocal folds during voice production. Functional dysphonia is a voice disorder in the absence of structual or neurogenic laryngeal characteristics. A near consensus exist that Muscle tension dysphonia (MTD) is functional voice disorder wherein hyperfunctional laryngeal muscle activity whereas Spasmodic dysphonia (SD) is neurogenic, action-induced focal laryngeal dystonia including several subtype. Both Adductor type spasmodic dysphonia (AdSD) and MTD may be associated with excessive supraglottic contraction and compensation, resulting in a strained voice quality with spastic voice breaks. It makes these two disorders extremely difficult to differentiate based on clinical interpretation alone. Because treatment for AdSD and MTD are quite different, correct diagnosis is important. Clinician should be aware of the specific vocal characteristics of each disease to improve therapeutic outcome.

Keyword

Functional dysphonia; Neurogenic dysphonia; Muscle tension dysphonia; Spasmodic dysphonia; Differential diagnosis

MeSH Terms

Amyotrophic Lateral Sclerosis
Central Nervous System
Compensation and Redress
Consensus
Diagnosis
Diagnosis, Differential*
Dyskinesias
Dysphonia*
Dystonia
Laryngeal Muscles
Larynx
Muscle Spasticity
Muscle Tonus
Myasthenia Gravis
Parkinson Disease
Vocal Cord Paralysis
Vocal Cords
Voice
Voice Disorders
Voice Quality
Full Text Links
  • JKSLPL
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr