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Laryngeal Dystonia (laryngeal + dystonia)

Distribution by Scientific Domains

Medical Sciences	100%

Selected Abstracts

Paramedical treatment in primary dystonia: A systematic review,

MOVEMENT DISORDERS, Issue 15 2009
Cathérine C.S. Delnooz MD
Abstract Dystonia is a disabling movement disorder with a significant impact on quality of life. The current therapeutic armamentarium includes various drugs, botulinum toxin injections, and occasionally (neuro)surgery. In addition, many patients are referred for paramedical (including allied health care) interventions. An enormous variation in the paramedical treatment is provided, largely because evidence-based, accepted treatment regimes are not available. We have conducted a systematic review of studies that explored the effect of various paramedical interventions in primary dystonia. Only studies that have used clinical outcome measures were included. There were no class A1 or A2 studies and therefore, level 1 or 2 practice recommendations for a specific intervention could not be deducted. Many papers were case reports, mostly with a very limited number of patients and a clear publication bias for beneficial effects of a particular paramedical intervention. Some potentially interesting interventions come from class B studies, which include physical therapy in addition to botulinum toxin injections (BoNT-A) in cervical dystonia; sensorimotor training and transcutaneous electrical nerve stimulation (TENS) in writer's cramp; and speech therapy added to BoNT-A injections in laryngeal dystonia. Good quality clinical studies are therefore warranted, which should have the aim to be generally applicable. A design in which the paramedical intervention is added to a current gold standard, for example, BoNT-A injections in cervical dystonia, is recommended. © 2009 Movement Disorder Society [source]

Sleep-related stridor due to dystonic vocal cord motion and neurogenic tachypnea/tachycardia in multiple system atrophy

MOVEMENT DISORDERS, Issue 5 2007
Roberto Vetrugno MD
Abstract Sleep-disordered breathing and sleep-related motor phenomena are part of the clinical spectrum of multiple system atrophy (MSA). Stridor has been attributed to denervation of laryngeal muscles or instead to dystonic vocal cord motion. We studied 3 patients with nocturnal stridor in the setting of MSA. All patients underwent nocturnal videopolysomnography (VPSG) with breathing and heart rate, O2 saturation and intra-esophageal pressure recordings, and simultaneous EMG recordings of the posterior cricoarytenoid, cricothyroid, and thyroarytenoid muscles and continuous vocal cord motion evaluation by means of fiberoptic laryngoscopy. VPSG/EMG and fiberoptic laryngoscopy documented normal vocal cord motion without denervation during wake and stridor only during sleep when hyperactivation of vocal cords adductors appeared in the absence of significant O2 desaturation. All patients had tachycardia and tachypnea and paradoxical breathing during sleep, erratic intercostalis and diaphragmatic EMG activity and Rem sleep behavior disorder. One of the patients had restless legs syndrome with periodic limb movement during sleep and excessive fragmentary hypnic myoclonus. In conclusion, our patients with MSA had nocturnal stridor due to sleep-related laryngeal dystonia. Stridor was associated with other abnormal sleep-related respiratory and motor disorders, suggesting an impairment of homeostatic brainstem integration in MSA. © 2007 Movement Disorder Society [source]

Prevalence study of primary dystonia in Iceland

MOVEMENT DISORDERS, Issue 3 2006
Hilmir Asgeirsson STUD MED
Abstract In Iceland, the crude prevalence for all types of primary dystonia was 37.1/105 (confidence interval, 30.4,44.9). Focal dystonia had the highest prevalence (31.2/105), followed by segmental (3.1/105), multifocal (2.4/105) and generalized dystonia (0.3/105). Cervical dystonia was the most common focal dystonia (11.5/105), followed by limb dystonia (8.0/105), laryngeal dystonia (5.9/105), blepharospasm (3.1/105), and oromandibular dystonia (2.8/105). The male:female ratio for all patients was 1:1.9 (P = 0.0007), and females outnumbered males in all subtypes except oromandibular dystonia. Mean age of onset for all patients was 42.7 years (range, 3,82 years). This prevalence of primary dystonia is higher than in most reported studies, possibly because of more complete ascertainment but the relative frequencies of dystonia subtypes is similar. © 2005 Movement Disorder Society [source]

Task Specificity in Adductor Spasmodic Dysphonia Versus Muscle Tension Dysphonia

THE LARYNGOSCOPE, Issue 2 2005
Nelson Roy PhD
Abstract Objectives: Adductor spasmodic dysphonia (ADSD) has been characterized as a "task specific" laryngeal dystonia, meaning that the severity of dysphonia varies depending on the demands of the vocal task. Voice produced in connected speech as compared with sustained vowels is said to provoke more frequent and severe laryngeal spasms. This study examined the diagnostic value of "task specificity" as a marker of ADSD and its potential to differentiate ADSD from muscle tension dysphonia (MTD), a functional voice disorder that can often masquerade as ADSD. Study Design: Case-control study. Methods: Five listeners, blinded to the purpose of the study, used a 10 cm visual analogue scale to rate dysphonia severity of subjects with ADSD (n = 36) and MTD (n = 45) producing either connected speech or a sustained vowel "ah." Results: In ADSD, dysphonia severity for connected speech (M = 6.22 cm, SD = 2.56) was rated significantly more severe than sustained vowel productions (M = 4.8 cm, SD = 2.8 [t (35) = 3.67, P < .001]). In MTD, however, no significant difference in severity was observed for the connected speech sample (M = 5.98 cm, SD = 2.83 versus the sustained vowel M = 5.86 cm, SD = 2.87 [t (44) = 0.378, P = .707]). The receiver operating characteristic (ROC) curve, an index of the accuracy of task specificity as a diagnostic marker, revealed that a 1 cm difference criterion correctly identified 53% of ADSD cases (sensitivity) and 76% of MTD cases (specificity) (,2 (1) = 6.88, P = .0087). Conclusions: Reduced dysphonia severity during sustained vowels supports task specificity in ADSD but not MTD and highlights a valuable diagnostic marker whose recognition should contribute to improved diagnostic precision. [source]