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Upper Motor Neuron Diseases and Laryngeal Presentations

  • Neurolaryngology (AJ McWhorter and L Adkins, Section Editors)
  • Published:
Current Otorhinolaryngology Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

The purpose of this manuscript is to review laryngeal manifestations of upper motor neuron disease. A review of the relevant neuroanatomy is performed as well as a description of common laryngeal signs of upper motor neuron disease and the disease entities that cause them.

Recent Findings

Upper motor neuron lesions must occur in the brainstem or in the bilateral cerebral hemisphere in order to cause signs and symptoms in the larynx.

Summary

The presence of bilateral vocal fold paralysis or paresis with concurrent signs of myoclonus, tremor, rigidity, hyperactive gag reflex, and/or laryngospasm episodes should prompt an investigation for possible medullary brainstem or bilateral cerebral cortex pathology.

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Author information

Authors and Affiliations

  1. Philadelphia Voice Center, PO BOX 2878, Bala Cynwyd, PA, 19004, USA

    Yolanda D. Heman-Ackah

  2. Department of Otolaryngology-Head and Neck Surgery, Drexel University College of Medicine, Philadelphia, PA, USA

    Yolanda D. Heman-Ackah

  3. Department of Otolaryngology-Head and Neck Surgery, Thomas Jefferson University Sidney Kimmel Medical School, Philadelphia, PA, USA

    Yolanda D. Heman-Ackah

Authors
  1. Yolanda D. Heman-Ackah
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Correspondence to Yolanda D. Heman-Ackah.

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This article is part of the Topical collection on Neurolaryngology

Electronic supplementary material

ESM 1

Video 1. Resting tremor in the larynx. This video shows a rhythmic tremor of the laryngeal muscles at rest during quiet respiration. (Used with permission from Yolanda D. Heman-Ackah.) (WMV 1017 kb)

ESM 2

Video 2. Laryngeal intention tremor. This video shows absence of tremor at rest and the presence of a rhythmic tremor of the laryngeal muscles with sustained adduction of the vocal folds during phonation. (Used with permission from Yolanda D. Heman-Ackah.) (WMV 2070 kb)

ESM 3

Video 3. Laryngeal Myoclonus. This video shows myoclonic jerking movements of the laryngeal and pharyngeal constrictor muscles at rest. (Used with permission from Yolanda D. Heman-Ackah.) (WMV 664 kb)

ESM 4

Video 4. Laryngeal cogwheeling. This video shows rigidity in the laryngeal muscles as they attempt adduction following abduction. (Used with permission from Yolanda D. Heman-Ackah.) (MPG 2401 kb)

ESM 5

Video 5. Laryngeal dysdiadokinesis. This video shows difficulty alternating quickly between abduction and adduction of the vocal folds. (Used with permission from Yolanda D. Heman-Ackah.) (MPG 5194 kb)

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Heman-Ackah, Y.D. Upper Motor Neuron Diseases and Laryngeal Presentations. Curr Otorhinolaryngol Rep 8, 230–235 (2020). https://doi.org/10.1007/s40136-020-00292-9

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  • DOI: https://doi.org/10.1007/s40136-020-00292-9

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