Overview and Facts about Spasmodic Dysphonia
Spasmodic dysphonia is a neurological disorder that results in involuntary movements of the muscles in the larynx, or voice box. The disease can make it difficult to speak and often interferes with communication, causing the patient’s voice to sound strained, strangled, or tight.
Although it most often occurs on its own, this otolaryngology condition often manifests with other movement disorders, or dystonias, of the nervous system.
There are three different types of this disorder:
- Adductor spasmodic dysphonia causes the patient’s vocal cords to inappropriately stiffen and close
- Abductor spasmodic dysphonia causes the patient’s vocal cords to stay open improperly
- Mixed spasmodic dysphonia causes the vocal cords to function inappropriately, both staying open and closing inappropriately
Symptoms and Signs of Spasmodic Dysphonia
The most prominent sign of spasmodic dysphonia is difficulty speaking. Some people may struggle with saying just a few words, while others may have significant trouble communicating.
Patients often have difficulty talking, but can sing, laugh or yell without an issue. These symptoms may come on suddenly, or they may develop over time.
Tests and Diagnosis of Spasmodic Dysphonia
Spasmodic dysphonia is diagnosed by an otolaryngology specialist, a doctor who focuses on treating conditions of the ears, nose, and throat (ENT). The doctor makes the diagnosis after completing a clinical evaluation. This may include:
- Acoustic Analysis: Computer evaluation of multiple features of your voice assists in the diagnosis and treatment of your voice disorder. These measurements also serve as a way to objectively evaluate the progress that is made during and after treatments.
- Videostroboscopy: A flexible scope with a camera is inserted through the nose and fed into the larynx to visualize the vocal cords. A strobe light makes the vocal cords appear in slow motion and the examination is recorded. This study diagnoses and evaluates in detail the anatomy, physiology and any pathology of the vocal cords.
A complete neurological evaluation by a neurologist, They may also ask for imaging tests of the brain, including a CT scan or MRI, to rule out other neurological disorders.
Causes and Risk Factors of Spasmodic Dysphonia
Currently, the root cause of spasmodic dysphonia is unknown. However, it may be triggered by the basal ganglia, a section of the brain that controls involuntary body movements, including those that occur in the larynx.
In some cases, symptoms of spasmodic dysphonia occur after an illness or injury to the voice box, or the symptoms may appear during times of emotional stress. In other cases, patients may have no identifiable reason for the manifestation of spasmodic dysphonia symptoms.
Although anyone can develop this otolaryngology condition, certain risk factors may increase the chance of getting the disorder.
Those who have family members with spasmodic dysphonia or other neurological disorders have a higher risk of developing the disease, since the condition may be genetic. Also, environmental factors may put certain patients at a higher risk.
Treatment and Care for Spasmodic Dysphonia
There is no cure for spasmodic dysphonia, but the symptoms can be treated. Depending on how the condition impacts speech, the doctor may recommend:
- Speech therapy
- Botulinum toxin (Botox) injections into the vocal cord, stopping the muscle spasms
- Surgery to aid the larynx in relaxing the vocal fold spasms
- Psychological counseling
When necessary, the doctor may suggest using an augmentative device to assist in communication. This could include a voice amplifier or mobile device that provides synthetic speech.
