Spasmodic Dysphonia
Condition
(SD; Adductor Laryngeal Breathing Dystonia (ABLD); Adductor Spasmodic Dysphonia; Abductor Spasmodic Dysphonia; Dysphonia, Episodic Laryngeal Dyskinesia; Laryngeal Dystonia; Spastic Dysphonia)
Definition
Spasmodic dysphonia (SD) is a voice disorder. The muscles of the throat freeze or go into spasms. This makes it hard to speak.
The main types of SD are:
- Adductor spasmodic dysphonia—spasms make muscles stiffen and close
- Abductor spasmodic dysphonia—spasms make muscles spastically open
- Mixed spasmodic dysphonia
Spasmodic dysphonia affects the throat muscles.
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Causes
SD is caused by a problem with the central nervous system. The areas of the brain that control these muscle movements are deep within the brain.
Risk Factors
SD is more common in women and people who are between 30 and 50 years of age.
Other things that may raise the risk are:
- Brain diseases such as amyotrophic lateral sclerosis (ALS)
- Another movement disorder such as tardive dyskinesia
- Having other family members with SD
- Brain infection, such as encephalitis
- Exposure to toxins
- Some medicines, such as phenothiazines
- Using the voice a lot
Symptoms
A person with SD may have:
- Squeaky, strained speech
- No speech at all
- Speech with the wrong pitch and tone
- Breaks in speech
- A breathy voice
Diagnosis
The doctor will ask about symptoms and health history. A physical exam will be done.
Images may be taken. This can be done with:
Other doctors may need to be seen, such as:
- Neurologist—to check brain function
- Speech pathologist—to check speech and how it is made
- Otolaryngologist—to check the vocal cords
Treatment
There is no cure for SD. The goal of treatment is to manage symptoms. Choices are:
- Speech therapy
- Medicines to relax the muscles needed to speak
- Devices to help with communication
- Counseling to learn to cope with SD
People who are not helped by other methods may need surgery to cut or remove a nerve that is connected to the vocal cords.
Prevention
There are no current guidelines to prevent SD.
American Speech-Language-Hearing Association
National Spasmodic Dysphonia Association
CANADIAN RESOURCES:
Health Canada
Speech-Language and Audiology Canada
American Speech-Language-Hearing Association
National Spasmodic Dysphonia Association
CANADIAN RESOURCES:
Health Canada
Speech-Language and Audiology Canada
References
- Hintze, J.M., Ludlow, C.L., et al. Spasmodic dysphonia: A review. Part 1: Pathogenic factors. Otolaryngol Head Neck Surg, 2017; 157 (4): 551-557.
- Hintze, J.M., Ludlow, C.L., et al. Spasmodic dysphonia: A review. Part 2:Characterization of pathophysiology. Otolaryngol Head Neck Surg, 2017; 157 (4): 558-564.
- Hoarseness - approach to the patient. EBSCO DynaMed website. Available at: https://www.dynamed.com/approach-to/hoarseness-approach-to-the-patient.
- Spasmodic dysphonia. American Speech-Language-Hearing Association website. Available at: https://www.asha.org/public/speech/disorders/spasmodic-dysphonia.
- Spasmodic dysphonia. National Institute on Deafness and Other Communicative Disorders website. Available at: https://www.nidcd.nih.gov/health/spasmodic-dysphonia.
- Spasmodic dysphonia. National Spasmodic Dysphonia Association website. Available at: https://dysphonia.org/voice-conditions/spasmodic-dysphonia.
Contributors
- Rimas Lukas, MD
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