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Updated: June 1, 2025
He had an almost complete aphonia, spoke hoarsely and in a whisper and presented all the signs of abductor laryngeal paralysis; added to which there was a partial hemiplegia of the right side involving the upper and lower extremities, but not the face or any of the cranial nerves other than that supplying the right laryngeal abductor.
Then there was a woman afflicted with nervous aphonia, who after months of absolute dumbness had just recovered her voice at the moment when the Blessed Sacrament went by at the head of the four o'clock procession.
The history of headaches, fainting spells without marked impairment of consciousness, vomiting spells, hemianaesthesia, hemianalgesia, complete aphonia and an exaggerated paralysis, not only of the right leg, but of the ability to thrust out the tongue, while at the same time all other cranial functions were unimpaired together with the apparent health of the individual in every other respect, make up a syndrome hardly to pass unrecognized.
Next, a resonant bass voice said with a sort of indolent incisiveness: "Aphon or aphonia means loss of speech to the extent of, to the extent of oh, to WHAT extent, most learned Vera Vasilievna?" "To the extent of total loss of power of articulation," replied a voice feminine and youthful of timbre.
At first this seemed unaccountable, but later it was found that the old woman for whom the patient had been caring had a "stroke" with loss of the power to speak, though no aphonia.
He told me that the knife had just missed, by a hair's breadth, the carotid artery, but unfortunately it had struck the cervical plexus, that important nerve-plexus, situated in the side of the neck; and had cut the recurrent laryngeal nerve, which arises from the cervical plexus and supplies the muscles of the larynx; and it had thereby caused instant paralysis of those muscles, and aphonia, or loss of voice.
Schneider, the father of rhinology, mentions a woman in whom the odor of orange-flowers produced syncope. Odier has known a woman who was affected with aphonia whenever exposed to the odor of musk, but who immediately recovered after taking a cold bath. Dejean has mentioned a man who could not tolerate an atmosphere of cherries.
In fact he believed his condition was permanent and incurable especially since he had been treated at various neurological clinics for many weeks past without the slightest improvement or progress. Were we to follow up this history we could unearth the full life history of this patient, including the genesis of his early attack of aphonia.
It was shown that the present attack of paralysis and aphonia, symptoms of an unusually severe character, followed an unusually bitter quarrel which had lasted for a whole day and into the night of the attack. The question arises at this point, "Why did this attack take the form of a paralysis?"
In some places complete analgesia obtains. Reaction to touch is likewise diminished and recognition of heat and cold is impaired. Speech There is complete loss of the ability to make any sound, either voiced or whispered; that is to say, there is complete aphonia, there is loss of all voice. The patient understands everything, however, and writes her answers to questions rapidly and correctly.
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