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Weak voice

MedGen UID:
66033
Concept ID:
C0241700
Finding
Synonyms: Fatigue, Voice; Fatigues, Voice; Voice Fatigue; Voice Fatigues
SNOMED CT: Decreased vocal loudness (8614008); Vocal fatigue (8614008); Voice fatigue (8614008); Weakness of voice (8614008)
 
HPO: HP:0001621

Definition

Reduced intensity (volume) of speech. [from HPO]

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVWeak voice

Conditions with this feature

Congenital laryngeal abductor palsy
MedGen UID:
96004
Concept ID:
C0396059
Congenital Abnormality
Laryngeal abductor paralysis is an autosomal dominant condition characterized by variable penetrance and expressivity ranging from mild symptoms to neonatal asphyxia. (summary by Morelli et al., 1982; Manaligod and Smith, 1998).
Mulibrey nanism syndrome
MedGen UID:
99347
Concept ID:
C0524582
Disease or Syndrome
Mulibrey nanism (MUL) is a rare autosomal recessive growth disorder with prenatal onset, including occasional progressive cardiomyopathy, characteristic facial features, failure of sexual maturation, insulin resistance with type 2 diabetes, and an increased risk for Wilms tumor (summary by Hamalainen et al., 2006).
Brown-Vialetto-van Laere syndrome 1
MedGen UID:
163239
Concept ID:
C0796274
Disease or Syndrome
Brown-Vialetto-Van Laere syndrome is a rare autosomal recessive neurologic disorder characterized by sensorineural hearing loss and a variety of cranial nerve palsies, usually involving the motor components of the seventh and ninth to twelfth (more rarely the third, fifth, and sixth) cranial nerves. Spinal motor nerves and, less commonly, upper motor neurons are sometimes affected, giving a picture resembling amyotrophic lateral sclerosis (ALS; 105400). The onset of the disease is usually in the second decade, but earlier and later onset have been reported. Hearing loss tends to precede the onset of neurologic signs, mostly progressive muscle weakness causing respiratory compromise. However, patients with very early onset may present with bulbar palsy and may not develop hearing loss until later. The symptoms, severity, and disease duration are variable (summary by Green et al., 2010). Genetic Heterogeneity of Brown-Vialetto-Van Laere Syndrome See also BVVLS2 (614707), caused by mutation in the SLC52A2 gene (607882) on chromosome 8q.
Uruguay Faciocardiomusculoskeletal syndrome
MedGen UID:
335320
Concept ID:
C1846010
Disease or Syndrome
Uruguay faciocardiomusculoskeletal syndrome (FCMSU) is an X-linked disorder in which affected males have a distinctive facial appearance, muscular hypertrophy, and cardiac ventricular hypertrophy leading to premature death. Additional features include large, broad, and deformed hands and feet, congenital hip dislocation, and scoliosis (summary by Xue et al., 2016).
Perry syndrome
MedGen UID:
357007
Concept ID:
C1868594
Disease or Syndrome
The spectrum of DCTN1-related neurodegeneration includes Perry syndrome, distal hereditary motor neuronopathy type 7B (dHMN7B), frontotemporal dementia (FTD), motor neuron disease / amyotrophic lateral sclerosis (ALS), and progressive supranuclear palsy. Some individuals present with overlapping phenotypes (e.g., FTD-ALS, Perry syndrome-dHMN7B). Perry syndrome (the most common of the phenotypes associated with DCTN1) is characterized by parkinsonism, neuropsychiatric symptoms, hypoventilation, and weight loss. The mean age of onset in those with Perry syndrome is 49 years (range: 35-70 years), and the mean disease duration is five years (range: 2-14 years). In most affected persons, the reported cause/circumstance of death relates to sudden death/hypoventilation or suicide.
Parkinson disease, late-onset
MedGen UID:
463618
Concept ID:
C3160718
Disease or Syndrome
Generally, Parkinson's disease that begins after age 50 is called late-onset disease. The condition is described as early-onset disease if signs and symptoms begin before age 50. Early-onset cases that begin before age 20 are sometimes referred to as juvenile-onset Parkinson's disease.\n\nParkinson's disease can also affect emotions and thinking ability (cognition). Some affected individuals develop psychiatric conditions such as depression and visual hallucinations. People with Parkinson's disease also have an increased risk of developing dementia, which is a decline in intellectual functions including judgment and memory.\n\nOften the first symptom of Parkinson's disease is trembling or shaking (tremor) of a limb, especially when the body is at rest. Typically, the tremor begins on one side of the body, usually in one hand. Tremors can also affect the arms, legs, feet, and face. Other characteristic symptoms of Parkinson's disease include rigidity or stiffness of the limbs and torso, slow movement (bradykinesia) or an inability to move (akinesia), and impaired balance and coordination (postural instability). These symptoms worsen slowly over time.\n\nParkinson's disease is a progressive disorder of the nervous system. The disorder affects several regions of the brain, especially an area called the substantia nigra that controls balance and movement.
Early-onset Parkinson disease 20
MedGen UID:
816154
Concept ID:
C3809824
Disease or Syndrome
Parkinson disease-20 is an autosomal recessive neurodegenerative disorder characterized by young adult-onset of parkinsonism. Additional features may include seizures, cognitive decline, abnormal eye movements, and dystonia (summary by Krebs et al., 2013 and Quadri et al., 2013). For a phenotypic description and a discussion of genetic heterogeneity of Parkinson disease, see PD (168600).
Schwartz-Jampel syndrome type 1
MedGen UID:
1647990
Concept ID:
C4551479
Disease or Syndrome
Schwartz-Jampel syndrome type 1 (SJS1) is a rare autosomal recessive disorder characterized by muscle stiffness (myotonia) and chondrodysplasia. Affected individuals usually present in childhood with permanent muscle stiffness or bone deformities. Common clinical features include mask-like facies (narrow palpebral fissures, blepharospasm, and pursed lips); permanent muscle stiffness with continuous skeletal muscle activity recorded on electromyography; dwarfism; pectus carinatum; kyphoscoliosis; bowing of long bones; and epiphyseal, metaphyseal, and hip dysplasia. The disorder is slowly progressive but does not appear to alter life span (summary by Stum et al., 2006).
Spinal muscular atrophy, infantile, James type
MedGen UID:
1764556
Concept ID:
C5436669
Disease or Syndrome
The phenotypic spectrum of GARS1-associated axonal neuropathy ranges from GARS1 infantile-onset SMA (GARS1-iSMA) to GARS1 adolescent- or early adult-onset hereditary motor/sensory neuropathy (GARS1-HMSN). GARS1-iSMA. Age of onset ranges from the neonatal period to the toddler years. Initial manifestations are typically respiratory distress, poor feeding, and muscle weakness (distal greater than proximal). Weakness is slowly progressive, ultimately requiring mechanical ventilation and feeding via gastrostomy tube. GARS1-HMSN. Age of onset is most commonly during the second decade (range eight to 36 years). Initial manifestations are typically muscle weakness in the hands sometimes with sensory deficits. Lower limb involvement (seen in ~50% of individuals) ranges from weakness and atrophy of the extensor digitorum brevis and weakness of toe dorsiflexors to classic peroneal muscular atrophy with foot drop and a high steppage gait.
Myasthenic syndrome, congenital, 7B, presynaptic, autosomal recessive
MedGen UID:
1794157
Concept ID:
C5561947
Disease or Syndrome
Autosomal recessive presynaptic congenital myasthenic syndrome-7B (CMS7B) is characterized by severe generalized muscle weakness apparent from birth; decreased fetal movements may be apparent in utero. Affected infants have generalized hypotonia with poor cry and feeding, head lag, and facial muscle weakness with ptosis. Some patients may have respiratory involvement. Electrophysiologic studies show decreased compound muscle action potentials (CMAPs) and a decremental response to repetitive nerve stimulation. Treatment with 3,4-diaminopyridine and pyridostigmine may result in clinical improvement (summary by Bauche et al., 2020).
Dystonia 31
MedGen UID:
1794211
Concept ID:
C5562001
Disease or Syndrome
Dystonia-31 (DYT31) is an autosomal recessive progressive neurologic disorder characterized by involuntary muscle twisting movements and postural abnormalities affecting the upper and lower limbs, neck, face, and trunk. Some patients may have orofacial dyskinesia resulting in articulation and swallowing difficulties. The age at onset ranges from childhood to young adulthood. There are usually no additional neurologic symptoms, although late-onset parkinsonism was reported in 1 family (summary by Zech et al., 2022).

Professional guidelines

PubMed

Yoshida Y, Horiuchi K, Okamoto T
Thyroid 2020 May;30(5):681-687. Epub 2020 Feb 6 doi: 10.1089/thy.2019.0420. PMID: 31910100Free PMC Article
Smeltzer SC, Skurnick JH, Troiano R, Cook SD, Duran W, Lavietes MH
Chest 1992 Feb;101(2):479-84. doi: 10.1378/chest.101.2.479. PMID: 1735276
Ossoff RH, Sisson GA, Duncavage JA, Moselle HI, Andrews PE, McMillan WG
Laryngoscope 1984 Oct;94(10):1293-7. doi: 10.1288/00005537-198410000-00006. PMID: 6482626

Recent clinical studies

Etiology

Chorney SR, Zur KB, Buzi A, McKenna Benoit MK, Chennupati SK, Kleinman S, DeMauro SB, Elden LM
Ann Otol Rhinol Laryngol 2021 Mar;130(3):292-297. Epub 2020 Aug 14 doi: 10.1177/0003489420950370. PMID: 32795099Free PMC Article
Prasad M, Glueck M, Ceballos-Saenz D, Zapata-Aldana E, Johnson N, Campbell C, Nguyen CE
J Neuromuscul Dis 2019;6(3):341-347. doi: 10.3233/JND-180345. PMID: 31227653
Saters TL, Ribeiro VV, Siqueira LTD, Marotti BD, Brasolotto AG, Silverio KCA
J Voice 2018 Jul;32(4):449-458. Epub 2017 Aug 24 doi: 10.1016/j.jvoice.2017.06.018. PMID: 28844805
Bovo R, Trevisi P, Emanuelli E, Martini A
Int J Occup Med Environ Health 2013 Jun;26(3):363-72. Epub 2013 Jul 1 doi: 10.2478/s13382-013-0115-1. PMID: 23817868
Iqbal K, Udaipurwala IH, Khan SA, Jan AA, Jalisi M
J Pak Med Assoc 1996 Dec;46(12):274-6. PMID: 9000828

Diagnosis

Ng CH, Rahman M, Damrose EJ
JAMA Otolaryngol Head Neck Surg 2024 Apr 1;150(4):349-350. doi: 10.1001/jamaoto.2024.0057. PMID: 38451545
Chorney SR, Zur KB, Buzi A, McKenna Benoit MK, Chennupati SK, Kleinman S, DeMauro SB, Elden LM
Ann Otol Rhinol Laryngol 2021 Mar;130(3):292-297. Epub 2020 Aug 14 doi: 10.1177/0003489420950370. PMID: 32795099Free PMC Article
Tonon IG, Gomes NR, Teixeira LC, Medeiros AM
Codas 2020;32(2):e20180141. Epub 2020 Feb 10 doi: 10.1590/2317-1782/20192018141. PMID: 32049096
Donaghy PC, Barnett N, Olsen K, Taylor JP, McKeith IG, O'Brien JT, Thomas AJ
Int J Geriatr Psychiatry 2017 Nov;32(11):1163-1171. Epub 2017 May 29 doi: 10.1002/gps.4742. PMID: 28556415
Kernich CA, Kaminski HJ
J Neurosci Nurs 1995 Aug;27(4):207-15; quiz 216-8. doi: 10.1097/01376517-199508000-00003. PMID: 7499922

Therapy

Gopal J, Haldar R, Mayilvaganan S, Dengre A
A A Pract 2022 Nov 1;16(11):e01638. Epub 2022 Nov 11 doi: 10.1213/XAA.0000000000001638. PMID: 36599037
Blackshaw H, Carding P, Jepson M, Mat Baki M, Ambler G, Schilder A, Morris S, Degun A, Yu R, Husbands S, Knowles H, Walton C, Karagama Y, Heathcote K, Birchall M
BMJ Open 2017 Sep 29;7(9):e016871. doi: 10.1136/bmjopen-2017-016871. PMID: 28965097Free PMC Article
Bovo R, Trevisi P, Emanuelli E, Martini A
Int J Occup Med Environ Health 2013 Jun;26(3):363-72. Epub 2013 Jul 1 doi: 10.2478/s13382-013-0115-1. PMID: 23817868
Iqbal K, Udaipurwala IH, Khan SA, Jan AA, Jalisi M
J Pak Med Assoc 1996 Dec;46(12):274-6. PMID: 9000828
Dudley JP, Mancuso AA, Fonkalsrud EW
Arch Otolaryngol 1984 Jul;110(7):483-4. doi: 10.1001/archotol.1984.00800330065015. PMID: 6732593

Prognosis

Nteli Chatzioglou G, Sari E, Gayretli Ö, Coşkun O, Öztürk A, Gürses İA
Otolaryngol Pol 2023 Jan 14;77(2):24-29. doi: 10.5604/01.3001.0016.2167. PMID: 37347976
Nteli Chatzioglou G, Sari E, Gayretli Ö, Coşkun O, Ozturk A, Gürses İA
Otolaryngol Pol 2023 Jan 14;77(2):1-4. doi: 10.5604/01.3001.0016.2167. PMID: 36804775
Yoshida Y, Horiuchi K, Okamoto T
Thyroid 2020 May;30(5):681-687. Epub 2020 Feb 6 doi: 10.1089/thy.2019.0420. PMID: 31910100Free PMC Article
Bovo R, Trevisi P, Emanuelli E, Martini A
Int J Occup Med Environ Health 2013 Jun;26(3):363-72. Epub 2013 Jul 1 doi: 10.2478/s13382-013-0115-1. PMID: 23817868
Iqbal K, Udaipurwala IH, Khan SA, Jan AA, Jalisi M
J Pak Med Assoc 1996 Dec;46(12):274-6. PMID: 9000828

Clinical prediction guides

Chorney SR, Zur KB, Buzi A, McKenna Benoit MK, Chennupati SK, Kleinman S, DeMauro SB, Elden LM
Ann Otol Rhinol Laryngol 2021 Mar;130(3):292-297. Epub 2020 Aug 14 doi: 10.1177/0003489420950370. PMID: 32795099Free PMC Article
Prasad M, Glueck M, Ceballos-Saenz D, Zapata-Aldana E, Johnson N, Campbell C, Nguyen CE
J Neuromuscul Dis 2019;6(3):341-347. doi: 10.3233/JND-180345. PMID: 31227653
Bovo R, Trevisi P, Emanuelli E, Martini A
Int J Occup Med Environ Health 2013 Jun;26(3):363-72. Epub 2013 Jul 1 doi: 10.2478/s13382-013-0115-1. PMID: 23817868
Iqbal K, Udaipurwala IH, Khan SA, Jan AA, Jalisi M
J Pak Med Assoc 1996 Dec;46(12):274-6. PMID: 9000828
Smeltzer SC, Skurnick JH, Troiano R, Cook SD, Duran W, Lavietes MH
Chest 1992 Feb;101(2):479-84. doi: 10.1378/chest.101.2.479. PMID: 1735276

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