During clinical examination, potential indicators of dysphagia include impaired consciousness, "National Institutes of Health Stroke Scale" score >12, aphasia, hypophonia
, dysarthria, severe neurologic deficit, marked facial paralysis, decreased pharyngeal sensation and wet sound, cough, and change of voice after swallowing.
Neurological findings were significant for paucity of expressive speech, hypophonia
, decreased facial expression, slow gait, tremors, and cogwheel rigidity.
PWP suffer from vocal and speech impairments such as dysphonia, hypophonia
, monotone and dysarthria .
Previous studies investigating the feasibility of online assessment have identified that PD symptoms such as hypophonia
(soft voice) may cause clinical raters difficulty in hearing the participant clearly, and symptoms of tremor, rigidity, dyskinesia, and bradykinesia may cause the participants difficulty using computers when needing steady hand movements to navigate a mouse [12, 20].
The patient was a 59-year-old right handed man with a diagnosis of Parkinson disease made at UTSW 6 years ago, who presented for DBS evaluation with severe right sided tremors (the initial symptoms) and milder left sided tremors affecting both upper and lower extremities along with other typical Parkinsonian symptoms such as rigidity and bradykinesia (predominantly right sided), hypophonia
, stuttering speech, and slow gait.
Also, it is important for PD patients who develop hypophonia
and other problems with speech production to be able to hear themselves and feedback from others (including speech pathologists) as clearly as possible [53, 54].
Some nurses are aware of the secondary motor manifestations: dysarthria, dysphagia, hypophonia
, micrographia, and the mask-like expression seen in some patients with Parkinson's disease.
General neurological examination showed difficulty in calculating, recent memory disturbance, hypophonia
, and slurred speech.
It has been reported that adverse effects occurred in 34%75% of the patients who were treated with BoNT-A, and the most common adverse effects were dysphagia, weakness in cervical muscles, hypophonia
, dry mouth, and atrophy of muscles (26,28).
Symptoms such as shuffling gait, loss of dexterity, festination, freezing of gait, hypophonia
and loss of articulation, and falls because of loss of postural reflexes.
is a symptom of PD, and at times it became difficult to hear participants and therefore direct the assessments across the Internet link.
It can include micrographia, hypomimia, hypophonia
as well as decreased blink rate.