title: Otolaryngologic presentations of amyotrophic lateralsclerosis.
abstract: OBJECTIVE
  To determine the incidence of voice disturbance as a presenting symptom of amyotrophic lateral sclerosis (ALS) and describe laryngologic features of ALS.
  
  
  METHODS
  Retrospective review.
  
  
  METHODS
  Records of patients with voice disturbance at a voice center and ALS patients at a neurology clinic were reviewed from January 1998 to March 2003.
  
  
  RESULTS
  15 of 1759 patients with voice disturbance were later diagnosed with ALS. Of 220 ALS patients presenting to neurology clinic, 44 had bulbar symptoms and 19 had initially presented to an otolaryngologist. Dysarthria, dysphagia, tongue fasciculation, and incomplete vocal fold closure were common findings. Neuromuscular disease was missed in 8 of 19 ALS patients seen by an otolaryngologist.
  
  
  CONCLUSIONS
  Although otolaryngologists rarely encounter undiagnosed ALS patients, a significant portion of bulbar ALS patients are initially evaluated by otolaryngologists.
  
  
  CONCLUSIONS
  Vigilance for neuromuscular abnormalities on otolaryngologic exam is important in patients who present with dysarthria, dysphonia, or dysphagia.
  
  
  METHODS
  C.
authors.affiliation: Vanderbilt Bill Wilkerson Center for Otolaryngology and Communication Sciences, Nashville, TN, USA.
authors.forename: Anton
authors.initials: A
authors.lastname: Chen
authors.forename: C Gaelyn
authors.initials: CG
authors.lastname: Garrett
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000690:Amyotrophic Lateral Sclerosis / Q000150:complications* / Q000453:epidemiology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D010038:Otorhinolaryngologic Diseases / Q000209:etiology*; D012189:Retrospective Studies