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Functional Aphonia

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41. Conversion Disorders (Diagnosis)

09, 2015 Author: Scott A Marshall, MD; Chief Editor: David Bienenfeld, MD Share Email Print Feedback Close Sections Sections Conversion Disorders Overview Background Conversion disorder (Functional Neurological Symptom Disorder) is categorized under the new Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) category of Somatic Symptom and Related Disorders. [ ] It involves symptoms or deficits affecting voluntary motor or sensory function that suggest a neurologic (...) or other general medical condition. Yet, following a thorough evaluation, which includes a detailed neurologic examination and appropriate laboratory and radiographic diagnostic tests, no neurologic explanation exists for the symptoms, or the examination findings are inconsistent with the complaint. In other words, symptoms of an organic medical disorder or disturbance in normal neurologic functioning exist that are not referable to an organic medical or neurologic cause. [ ] Common examples

2014 eMedicine.com

42. Enteroviruses (Diagnosis)

and weakness or paralysis of one or more extremities, along with weakness of one or more muscle groups Spinal polio comprises a prolonged prodrome, with features of aseptic meningitis followed in 1-2 days by weakness and, eventually, paralysis Bulbar polio involves cranial nerves, most commonly IX, X, and XII; patients accumulate pharyngeal secretions, have a nasal twang to the voice, and develop paralysis of vocal cords, causing hoarseness, aphonia, and, eventually, asphyxia Polioencephalitis (...) reduce poliovirus shedding; higher secretory IgA titers lead to better immunity. [ ] Immunoglobulin M (IgM) antibodies appear as early as 1-3 days after enteroviral challenge and disappear after 2-3 months. [ ] Immunoglobulin G (IgG) antibody, which is generally detected 7-10 days after infection, is mostly of the IgG 1 and IgG 3 subtypes. Serum neutralizing IgG antibodies persist for life after natural enteroviral infections. [ ] Macrophage function is also a critical component of the immune

2014 eMedicine.com

43. Somatoform Disorder: Somatization (Overview)

medical outpatient visits. [ ] Physical symptoms or painful complaints of unknown etiology are fairly common in pediatric populations. [ ] Many healthy young children express emotional distress in terms of physical pain, such as stomachaches or headaches, but these complaints are usually transient and do not effect the child's overall functioning. The somatoform disorders represent the severe end of a continuum of somatic symptoms. Somatization in children consists of the persistent experience (...) of resources through repeated hospitalizations, consultations from different specialists, and ineffective investigations and treatments. [ ] Somatoform disorders are associated with poor school performance and attendance and overall impaired functioning. [ ] Appropriate and timely diagnosis combined with collaborative psychiatric and medical interventions may decrease significant long-term morbidity and suffering. Clinical The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV

2014 eMedicine Pediatrics

44. Somatoform Disorder: Somatization (Follow-up)

medical outpatient visits. [ ] Physical symptoms or painful complaints of unknown etiology are fairly common in pediatric populations. [ ] Many healthy young children express emotional distress in terms of physical pain, such as stomachaches or headaches, but these complaints are usually transient and do not effect the child's overall functioning. The somatoform disorders represent the severe end of a continuum of somatic symptoms. Somatization in children consists of the persistent experience (...) of resources through repeated hospitalizations, consultations from different specialists, and ineffective investigations and treatments. [ ] Somatoform disorders are associated with poor school performance and attendance and overall impaired functioning. [ ] Appropriate and timely diagnosis combined with collaborative psychiatric and medical interventions may decrease significant long-term morbidity and suffering. Clinical The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV

2014 eMedicine Pediatrics

45. Somatoform Disorder: Somatization (Treatment)

medical outpatient visits. [ ] Physical symptoms or painful complaints of unknown etiology are fairly common in pediatric populations. [ ] Many healthy young children express emotional distress in terms of physical pain, such as stomachaches or headaches, but these complaints are usually transient and do not effect the child's overall functioning. The somatoform disorders represent the severe end of a continuum of somatic symptoms. Somatization in children consists of the persistent experience (...) of resources through repeated hospitalizations, consultations from different specialists, and ineffective investigations and treatments. [ ] Somatoform disorders are associated with poor school performance and attendance and overall impaired functioning. [ ] Appropriate and timely diagnosis combined with collaborative psychiatric and medical interventions may decrease significant long-term morbidity and suffering. Clinical The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV

2014 eMedicine Pediatrics

46. Somatoform Disorder: Somatization (Diagnosis)

medical outpatient visits. [ ] Physical symptoms or painful complaints of unknown etiology are fairly common in pediatric populations. [ ] Many healthy young children express emotional distress in terms of physical pain, such as stomachaches or headaches, but these complaints are usually transient and do not effect the child's overall functioning. The somatoform disorders represent the severe end of a continuum of somatic symptoms. Somatization in children consists of the persistent experience (...) of resources through repeated hospitalizations, consultations from different specialists, and ineffective investigations and treatments. [ ] Somatoform disorders are associated with poor school performance and attendance and overall impaired functioning. [ ] Appropriate and timely diagnosis combined with collaborative psychiatric and medical interventions may decrease significant long-term morbidity and suffering. Clinical The Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ( DSM-IV

2014 eMedicine Pediatrics

47. Toxicity, Chlorine Gas (Diagnosis)

Intercostal retractions Decreased breath sounds Rales (pulmonary edema) Nasal flaring Aphonia, stridor, or laryngeal edema Ulceration or hemorrhage of the respiratory tract Rhinorrhea Lacrimation, salivation, and blepharospasm Chloracne or tooth enamel corrosion (with chronic exposure) Redness, erythema, and chemical burns to the skin from dose-dependent exposure to liquid See for more detail. Diagnosis Studies in patients with significant exposure to chlorine gas may include the following: Pulse oximetry (...) Serum electrolyte, blood urea nitrogen (BUN), and creatinine levels Arterial blood gases Chest radiography Electrocardiogram (ECG) CT scan of the chest Ventilation-perfusion scan Pulmonary function testing Laryngoscopy or bronchoscopy Abnormalities include hypoxia (from bronchospasm or pulmonary edema) [ ] and metabolic acidosis. The metabolic acidosis may be hyperchloremic (nonanion gap). Chest radiograph findings are frequently normal initially but later may show nonspecific abnormalities

2014 eMedicine Emergency Medicine

48. Toxicity, Chlorine Gas (Follow-up)

Intercostal retractions Decreased breath sounds Rales (pulmonary edema) Nasal flaring Aphonia, stridor, or laryngeal edema Ulceration or hemorrhage of the respiratory tract Rhinorrhea Lacrimation, salivation, and blepharospasm Chloracne or tooth enamel corrosion (with chronic exposure) Redness, erythema, and chemical burns to the skin from dose-dependent exposure to liquid See for more detail. Diagnosis Studies in patients with significant exposure to chlorine gas may include the following: Pulse oximetry (...) Serum electrolyte, blood urea nitrogen (BUN), and creatinine levels Arterial blood gases Chest radiography Electrocardiogram (ECG) CT scan of the chest Ventilation-perfusion scan Pulmonary function testing Laryngoscopy or bronchoscopy Abnormalities include hypoxia (from bronchospasm or pulmonary edema) [ ] and metabolic acidosis. The metabolic acidosis may be hyperchloremic (nonanion gap). Chest radiograph findings are frequently normal initially but later may show nonspecific abnormalities

2014 eMedicine Emergency Medicine

49. Toxicity, Chlorine Gas (Overview)

Decreased breath sounds Rales (pulmonary edema) Nasal flaring Aphonia, stridor, or laryngeal edema Ulceration or hemorrhage of the respiratory tract Rhinorrhea Lacrimation, salivation, and blepharospasm Chloracne or tooth enamel corrosion (with chronic exposure) Redness, erythema, and chemical burns to the skin from dose-dependent exposure to liquid See for more detail. Diagnosis Studies in patients with significant exposure to chlorine gas may include the following: Pulse oximetry Serum electrolyte (...) , blood urea nitrogen (BUN), and creatinine levels Arterial blood gases Chest radiography Electrocardiogram (ECG) CT scan of the chest Ventilation-perfusion scan Pulmonary function testing Laryngoscopy or bronchoscopy Abnormalities include hypoxia (from bronchospasm or pulmonary edema) [ ] and metabolic acidosis. The metabolic acidosis may be hyperchloremic (nonanion gap). Chest radiograph findings are frequently normal initially but later may show nonspecific abnormalities, pulmonary edema

2014 eMedicine Emergency Medicine

50. Pilot Study of Stem Cell Treatment of Patients With Vocal Fold Scarring

Research Council Laryngfonden Karolinska Institutet Information provided by (Responsible Party): Stellan Hertegård, Karolinska University Hospital Study Details Study Description Go to Brief Summary: This is a pilot-study of 16 selected Swedish patients which all have severe hoarseness or aphonia due to vocal fold scarring (from previous surgery, radiation therapy, inflammation or possibly hereditary). The patients are operated with phonomicrosurgical dissection of the scarred vocal folds, removal (...) and at the Karolinska Institute. The laryngeal status, vocal fold function, and voice function will be followed individually with an advanced battery of examinations performed before and up to 1 year postoperatively. Side effects and complications are noted and reported during surgery and following surgery at regular intervals during at least 1 year Since spring 2015 no new patients have been recruited and no treatments are given during 2016 or 2017. The monitoring authority was changed from Swedish National Board

2013 Clinical Trials

51. Comparison of the Effect of Magnesium Sulfate and Dexamethasone on Postoperative Sore Throat After Spinal Surgery in Prone Position With Tracheal Intubation: a Double-blind, Randomized, Noninferiority Clinical Trial

hoarseness Severity of post operative hoarseness ( four-graded scale, 0= no hoarseness, 1= mild hoarseness, 2= severe hoarseness, 3= aphonia) Secondary Outcome Measures : The effect of dexamethasone on postoperative sore throat after spinal surgery in prone position with tracheal intubation [ Time Frame: Change of post operative sore throat level from 1 to 48 hours after surgery ] Incidence of post operative sore throat Severity of post operative sore throat (10 cm-visual analogue scale ) Incidence (...) of post operative hoarseness Severity of post operative hoarseness ( four-graded scale, 0= no hoarseness, 1= mild hoarseness, 2= severe hoarseness, 3= aphonia) Eligibility Criteria Go to Information from the National Library of Medicine Choosing to participate in a study is an important personal decision. Talk with your doctor and family members or friends about deciding to join a study. To learn more about this study, you or your doctor may contact the study research staff using the contacts provided

2013 Clinical Trials

52. Hoarseness

. Epidemiology Hoarseness is common, with a point as high as 7% for those <65 years old III. Pathophysiology Abnormal voice production (change in pitch, loudness or effort) Breathiness Harsh, rough or raspy voice Lack of smooth vocal cord approximation Laryngeal pathology Abnormal vocal cord mobility Usually caused by organic disorder (not functional) IV. Causes See V. Symptoms Abnormal voice quality (e.g. Breathy, Strained, Raspy, Weak) VI. History See VII. Evaluation: Laryngoscopy Indications (see (...) of the mucosa leading to VOICE DISORDERS such as APHONIA and HOARSENESS. Definition (CHV) an inflammation of the larynx (voice box) generally associated with hoarseness or loss of voice Definition (MSHCZE) Zánět hrtanu. Probíhá samostatně nebo častěji jako součást zánětu horních cest dýchacích. Nejčastěji má virový původ, ale může být způsobena i bakteriemi a zevními vlivy (dráždivé plyny, inverzní l. aj.). Projevuje se chrapotem až ztrátou hlasu (afonií) a kašlem. V těžkých případech, zejm. u malých dětí

2015 FP Notebook

53. A Note on Treatment of “Functional Aphonia” in Soldiers from the Front Full Text available with Trip Pro

A Note on Treatment of “Functional Aphonia” in Soldiers from the Front 19979267 2010 06 24 2010 06 24 0035-9157 9 Laryngol Sect 1916 Proceedings of the Royal Society of Medicine Proc. R. Soc. Med. A Note on Treatment of "Functional Aphonia" in Soldiers from the Front. 83-5 Milligan W W eng Journal Article England Proc R Soc Med 7505890 0035-9157 2009 12 9 6 0 1916 1 1 0 0 1916 1 1 0 1 ppublish 19979267 PMC2017491

1916 Proceedings of the Royal Society of Medicine

54. Conversion Disorder

to a stressful event. Typically, symptoms involve apparent deficits in voluntary motor or sensory function but sometimes include shaking movements and impaired consciousness (suggesting seizures) and abnormal limb posturing (suggesting another neurologic or general physical disorder). For example, patients may present with impaired coordination or balance, weakness, paralysis of an arm or a leg, loss of sensation in a body part, seizures, unresponsiveness, blindness, double vision, deafness, aphonia (...) for Patient Education NOTE: This is the Professional Version. CONSUMERS: Conversion disorder consists of neurologic symptoms or deficits that develop unconsciously and nonvolitionally and usually involve motor or sensory function. The manifestations are incompatible with known pathophysiologic mechanisms or anatomic pathways. Onset, exacerbation, or maintenance of conversion symptoms is commonly attributed to mental factors, such as stress. Diagnosis is based on history after excluding physical disorders

2013 Merck Manual (19th Edition)

55. Lipoid proteinosis

infiltration may cause upper respiratory tract infections, hoarseness or aphonia, dysphagia, and airway obstruction. Dystonia, seizures, behavioral changes, learning difficulties and short stature have been reported in affected children. Less commonly, the disease manifests in adulthood with subtle skin findings and possible complications due to visceral deposition. Heterozygous carriers are generally asymptomatic but may have a mild presentation including abnormal dentition. Etiology LP is caused (...) by deposition of an amorphous hyaline material in the skin, mucosa, and viscera. Causative loss-of-function mutations have been found in the ECM1 gene (1q21) encoding extracellular matrix protein 1, which has a role in physiology and homeostasis of the skin and many other tissues. Diagnostic methods Diagnosis is based on the clinical signs (particularly hoarseness and skin manifestations). Histological findings on biopsy of affected cutaneous or mucosal sites show periodic acid-Schiff-positive deposition

2005 Orphanet

56. Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis. (Abstract)

Laser microsurgical bilateral posterior cordectomy for the treatment of bilateral vocal fold paralysis. We performed a prospective study to assess respiratory function and voice quality before and after laser microsurgical bilateral posterior cordectomy performed for chronic airway obstruction in patients with bilateral vocal fold paralysis.In 17 patients a laser microsurgical posterior cordectomy was performed as an immediate bilateral approach. Roughness, breathiness, hoarseness, and dyspnea (...) were evaluated both subjectively (on a scale from 0 to 3) and objectively (body plethysmography, computerized voice analysis: Göttingen Hoarseness Diagram).After laser surgery, the patients' respiratory function was significantly increased and was sufficient for all activities of daily living. The body plethysmographic measure of airway resistance had superior descriptive power and correlated significantly with the clinical degree of dyspnea (scale 0 to 3). Pretreatment and posttreatment impairment

2005 Rhinology and Laryngology

57. Tracheoesophageal voice restoration following laryngotracheal separation procedure. (Abstract)

Tracheoesophageal voice restoration following laryngotracheal separation procedure. Laryngeal dysfunction leading to incompetence and intractable aspiration can be a life-threatening problem. Laryngotracheal separation (LTS) can be used to prevent aspiration, but results in aphonia. The options for laryngeal speech following LTS are limited.We performed tracheoesophageal puncture (TEP) and insertion of a Blom-Singer valve in 3 patients in an attempt to restore their voice after LTS for chronic (...) safe, and allows for the control of aspiration while maintaining vocal function.

2005 Rhinology and Laryngology

58. Polydimethylsiloxane particles for permanent injection laryngoplasty. (Abstract)

assessment before and after operation. Friedrich's dysphonia index (DI), a score system combining subjective and objective parameters, was used to describe voice quality. A DI of 0 reflects a normal voice, and a DI of 3 stands for complete aphonia. The PDMS particles were injected into the paraglottic space by microlaryngoscopy under general anesthesia.The median follow-up was 4.1 months. There was no complication attributable to the injection of PDMS particles. The mean DI was 2.8 before operation (...) . After the operation, voice quality improved significantly in each patient, as reflected by a mean postinjection DI of 1.4.Particles of PDMS provide a relatively safe and minimally invasive option for permanent vocal fold augmentation. The functional results in terms of voice improvement are comparable to those obtained with other techniques, including thyroplasty. In the European Community, PDMS particles are officially approved for use in the human larynx.

2006 Rhinology and Laryngology

59. Stridor

surgery. Presentation A careful history gives helpful clues as to the aetiological cause of the stridor. Examination may occasionally help confirm the diagnosis. It is important to consider the age of the patients and whether the stridor is acute or chronic. History Children: Age of onset. Duration, progression and severity of stridor. Precipitating factors (feeding, crying). Whether positional (worse right/left, prone/supine). Whether aphonia is present. Other symptoms (cough, aspiration, drooling (...) masses). MRI scanning (particularly for upper airway and vascular abnormalities). Virtual bronchoscopy. [ ] Other tests and procedures: Pulmonary function tests (differentiating restrictive/obstructive lesions and upper/lower airway obstruction). Laryngoscopy and bronchoscopy (after oxygen saturations are stable and acute epiglottitis excluded). Management This depends on the cause of the stridor. Management of the particular causes may be very different. However, the following general points can

2008 Mentor

60. Study of Air Stream in Voice Production

joint fixation or neoplasm. Any person with a functional voice disorder such as whispering aphonia or complete aphonia, or muscular tension dysphonia. Any person who report periods of symptom remission or are atypical of spasmodic dysphonia. Any person with oropharyngeal abnormalities such as velopharyngeal insufficiency, or neuromuscular disorders. Smokers and tobacco users. Any person who are currently under treatment for a major depression or manic-depressive illness, schizophrenia or a bipolar (...) Volunteers: Yes Criteria INCLUSION CRITERIA: Criteria for inclusion of patients with ABSD: General Criteria: Symptoms present during speech and not apparent at rest. Symptoms less evident during whisper, singing or falsetto. Symptoms which become worse with prolonged speaking, practice or anxiety. Reflexive and emotional aspects of voice function are unaffected, such as coughing, laughter or crying. No surgical treatment for ABSD or injections with botulinum toxin in the last 9 months. Willing to undergo

2001 Clinical Trials

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