Spasmodic dysphonia (SD) is a voice disorder. The muscles of the throat freeze or go into spasms. Words are strangled and strained or they don’t get out at all. Sounds are also distorted.
The main types of SD include: Adductor spasmodic dysphonia—spasms cause muscles to stiffen and closeAbductor spasmodic dysphonia—spasms cause muscles to spastically openMixed spasmodic dysphonia
Spasmodic dysphonia affects the throat muscles.
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Often, the exact cause of SD is unknown. It is a disorder of the central nervous system. The areas of the brain that control these muscle movements are deep within the brain.
This condition is more common in women and people who are between 30 and 50 years of age.
Factors that may increase your chance of developing SD include:
Degenerative brain diseases such as
amyotrophic lateral sclerosis
Another movement disorder such as
tardive dyskinesiaFamily history of SD—In some families, a gene on chromosome 9 may be connected to SD.
Brain infection such as
encephalitisExposure to toxins or certain medications such as phenothiazines
Symptoms of SD include: Squeaky, strained speechNo speech at allSpeech with the wrong pitch and toneBreaks in speechBreathy voice
You will be asked about your symptoms and medical history. A physical exam will be done.
Imaging tests evaluate the throat or other structures. These may include: MRI scanCT scan
You may be referred to a team of specialists, including: Neurologist—to evaluate your brain functionSpeech pathologist—to evaluate your speech and how it’s producedOtolaryngologist—to evaluate your vocal cords
Talk with your doctor about the best treatment plan for you. Treatment options include the following: Medication—to increase dopamine, a chemical in the brain that influences muscle movementBotulinum toxin injections—to reduce muscle spasmsSpeech therapy techniques—to relax musclesBrain stimulation—to prevent muscles from freezing and going into spasmCounseling—to help deal with the conditionSurgery in severe cases—to cut or remove a nerve that is connected to the vocal cords
There are no current guidelines to prevent SD because the cause is not known.
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Diagnosis. National Spasmodic Dysphonia Association website. Available at:
http://www.dysphonia.org/diagnosis.php. Accessed November 26, 2014.
Rosow DE, Parikh P, Vivero RJ, Casiano RR, Lundy DS. Considerations for initial dosing of botulinum toxin in treatment of adductor spasmodic dysphonia. Otolaryngol Head Neck Surg. 2013;148(6):1003-1006.
Spasmodic dysphonia. American Speech-Language-Hearing Association website. Available at:
http://www.asha.org/public/speech/disorders/SpasmodicDysphonia.htm. Accessed November 26, 2014.
Spasmodic dysphonia. National Institute on Deafness and Other Communicative Disorders website. Available at:
http://www.nidcd.nih.gov/health/voice/Pages/spasdysp.aspx. Updated October 2010. Accessed November 26, 2014.
Last reviewed November 2015 by Rimas Lukas, MD
Please be aware that this information is provided to supplement the care provided by your physician. It is neither intended nor implied to be a substitute for professional medical advice. CALL YOUR HEALTHCARE PROVIDER IMMEDIATELY IF YOU THINK YOU MAY HAVE A MEDICAL EMERGENCY. Always seek the advice of your physician or other qualified health provider prior to starting any new treatment or with any questions you may have regarding a medical condition.
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