Disfonia como principal queixa num quadro de miastenia grave: diagnóstico e fonoterapia

Nemr, Kátia; Simões-Zenari, Marcia; Ferreira, Tainá Soares; Fernandes, Heloisa Regina

doi:10.1590/s2317-17822013000300017

Cited by 10 publications

(6 citation statements)

References 12 publications

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“…These possible changes should be examined and the DRSP is an instrument that is able to detect such differences. In one patient referred for speech therapy, initial investigation and vocal assessment data contributed to the diagnosis of myasthenia gravis associated with presbyphonia, which was the reason for referral 24 .…”

Section: Discussionmentioning

confidence: 99%

Dysphonia risk screening protocol

Nemr¹,

Simões-Zenari²,

Duarte³

et al. 2016

Clinics

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OBJECTIVE:To propose and test the applicability of a dysphonia risk screening protocol with score calculation in individuals with and without dysphonia.METHOD:This descriptive cross-sectional study included 365 individuals (41 children, 142 adult women, 91 adult men and 91 seniors) divided into a dysphonic group and a non-dysphonic group. The protocol consisted of 18 questions and a score was calculated using a 10-cm visual analog scale. The measured value on the visual analog scale was added to the overall score, along with other partial scores. Speech samples allowed for analysis/assessment of the overall degree of vocal deviation and initial definition of the respective groups and after six months, the separation of the groups was confirmed using an acoustic analysis.RESULTS:The mean total scores were different between the groups in all samples. Values ranged between 37.0 and 57.85 in the dysphonic group and between 12.95 and 19.28 in the non-dysphonic group, with overall means of 46.09 and 15.55, respectively. High sensitivity and specificity were demonstrated when discriminating between the groups with the following cut-off points: 22.50 (children), 29.25 (adult women), 22.75 (adult men), and 27.10 (seniors).CONCLUSION:The protocol demonstrated high sensitivity and specificity in differentiating groups of individuals with and without dysphonia in different sample groups and is thus an effective instrument for use in voice clinics.

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Section: Discussionmentioning

confidence: 99%

Dysphonia risk screening protocol

Nemr¹,

Simões-Zenari²,

Duarte³

et al. 2016

Clinics

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“…Despite speech difficulties being a symptom of MG, to our knowledge there is a paucity of evidence on the benefits of tailored exercise regimens to improve speech in these patients. One case report of a patient whose dysphonia contributed to the diagnosis of MG showed benefit from drug therapy combined with speech therapy, which improved voice quality and great impact on quality of life (74).…”

Section: Respiratory Muscle Training In Mgmentioning

confidence: 99%

Myasthenia Gravis and Physical Exercise: A Novel Paradigm

2020

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The benefits of physical exercise for healthy individuals are well-established, particularly in relation to reducing the risks of chronic lifestyle related diseases. Furthermore, physical exercise has been seen to provide beneficial effects in many chronic diseases such as multiple sclerosis, rheumatoid arthritis, and chronic obstructive pulmonary disease and is therefore recommended as part of the treatment regimen. Myasthenia Gravis (MG) is a chronic autoimmune disease that causes neuromuscular transmission failure resulting in abnormal fatigable skeletal muscle weakness. In spite of this fluctuating skeletal muscle weakness, it is reasonable to assume that MG patients, like healthy individuals, could benefit from some of the positive effects of physical exercise. Yet exercise-related research in the field of MG is sparse and does not provide any guidelines on how MG patients should perform physical training in order to obtain exercise's favorable effects without risking disease deterioration or more pronounced muscle fatigue. A handful of recent studies report that MG patients with mild disease activity can adhere safely to general exercise recommendations, including resistance training and aerobic training regimens, without subjective or objective disease deterioration. These findings indicate that MG patients can indeed improve their functional muscle status as a result of aerobic and high-resistance strength training. This knowledge is important in order to establish collective as well as personalized guidelines on physical exercise for MG patients. This review discusses the present knowledge on physical exercise in MG.

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“…Similarly, hypophonia without obvious dysarthria is more commonly seen in PD [12] with slow but progressive speech intensity decay [12]. As stated earlier, few case reports have been published regarding bulbar weakness like dysphonia [13, 14] in MG. They argued that there is palatal and/or laryngeal weakness in MG [15] and it can be a presenting symptom in late-onset MG [14].…”

Section: Discussionmentioning

confidence: 99%

“…As stated earlier, few case reports have been published regarding bulbar weakness like dysphonia [13, 14] in MG. They argued that there is palatal and/or laryngeal weakness in MG [15] and it can be a presenting symptom in late-onset MG [14]. We present a relatively rarer presentation of MG. Our case had a sudden onset and fluctuating hypophonia without obvious palatal weakness or nasal tone.…”

Section: Discussionmentioning

confidence: 99%

Hypophonia as only presenting symptom in myasthenia gravis – a diagnostic dilemma in poor countries: a case report

Chandra

Pant

2019

J Med Case Reports

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Introduction The autoimmune disease myasthenia gravis can mimic a variety of neurological disorders leading to a delay in diagnosis and treatment. In the older population, due to confusion with signs of the ageing process or comorbidities due to ageing, there are many underdiagnosed or misdiagnosed cases of myasthenia gravis. A majority of myasthenia gravis symptoms appear as ocular or motor symptoms and there are very few cases of bulbar symptoms. We present a case of myasthenia gravis with only hypophonia as a clinical feature. Case presentation We present a case of a 51-year-old Madheshi woman whose only complaint was sudden onset of hypophonia which later showed a fluctuating nature throughout the daytime. There was only reduced pitch in her voice with no nasal tone or dysarthria (so-called dysphonia), which created a diagnostic dilemma. Later, a neurological examination and other relevant investigations suggested myasthenia gravis. Conclusions Sudden onset and focal neurological deficit can raise the diagnostic dilemma of myasthenia gravis. Relevant laboratory tests and clinical examinations are important to diagnose this disease properly. In resources-deprived nations like Nepal, where several investigations are expensive and access to them is difficult, it becomes very difficult to achieve a solid diagnosis for rare presentations of diseases.

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Disfonia como principal queixa num quadro de miastenia grave: diagnóstico e fonoterapia

Cited by 10 publications

References 12 publications

Dysphonia risk screening protocol

Dysphonia risk screening protocol

Myasthenia Gravis and Physical Exercise: A Novel Paradigm

Hypophonia as only presenting symptom in myasthenia gravis – a diagnostic dilemma in poor countries: a case report

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