Loss of Voice due to a Virus

[JR09]

I had a virus back in November 2008.  From that point on I have lost my voice little by little.  It is now 9 months later & I still have not gotten my voice back.  I have been to several doctors including Mayo, in Scottsdale, AZ and no diagnosis has been made.  My vocal cords have been checked and there fine.  It's more like the muscle is not working properly, causing me to have slurred speak.  My voice is better in the morning after I have rested, but the longer I use it, the worse it gets.  Any suggestions on how & if i'll ever get my voice back.

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

Loss of voice diction (volume, strength) is most often an ENT issue. If you have not been evaluated by an ENT specialist, that is the first route to go. Examination of the vocal cords under video/scope is important, to see if the vocal cords are moving properly during phonation. However, if all this is negative, and if you feel you have more of a problem with articulation rather than volume, there are several potential neurologic causes. The medical term would be dysarthria. If you feel that your voice gets weaker over the day and improves with rest, myasthenia gravis is one possibility, an autoimmune disorder that impairs signal transmission accross the nerve terminal to the muscle. However, isolated voice problems (without other symptoms such as double vision, difficulty swallowing, weakness of the arms or legs, droopy eyes) would make this diagnosis unlikely. This is also true for other muscle diseases that lead to dysarthria, such as certain types of myopathies, and nerve problems (cranial nerve palsies), and brain problems (such as brainstem problems), for which there are many many possible causes. The exact investigations again depend on your symptoms and associated symptoms, but may include blood tests, muscle tests (such as EMG) and imaging of the brain.

If you have not yet been evaluated by a neurologist, this would of benefit to you; evaluation by a local neuromuscular specialist (a neurologist specialized in muscle disorders) may be particularly useful if it is thought the cause of your symptoms is neurologic.

Thank you for using the forum I hope you find this information useful good luck.