Some neurological conditions, such as Parkinson's disease, ALS (amyotrophic lateral sclerosis), and myasthenia gravis, can affect the nerves that control the muscles in your voice box. When these nerves don't work properly, it can lead to a weak, soft, or hoarse voice and problems swallowing or speaking clearly. These voice changes might sometimes be the first sign of a more significant neurological issue, even before other symptoms appear.

In the doctor's office, specialists use tools like video laryngoscopy and sometimes electromyography (a test that measures muscle electrical activity) to examine how well your vocal cords are moving. Treatment typically involves working closely with a team including neurologists, ear–nose–throat doctors, and speech therapists. They often recommend voice therapy to help strengthen your vocal muscles and improve your speaking clarity. In some instances, if voice therapy alone isn't enough, doctors might suggest injections or surgery to support better vocal cord function. The improvement you see depends on the overall progress of the neurological condition, but early and targeted treatment can help you maintain better communication and quality of life.