What is Spasmodic Dysphonia

Spasmodic dysphonia is difficulty speaking that can cause the voice to sound strained, breathy, or hoarse. This condition may make it difficult to speak, or the voice may stop suddenly.

Spasmodic dysphonia is caused by involuntary movements (spasms) of certain muscles in the voice box (larynx), which keep the vocal cords from vibrating normally. Vocal cord vibration is what produces the voice.

There are two types of spasmodic dysphonia:

• Adductor spasmodic dysphonia is caused by the vocal cords closing suddenly, which causes the voice to stop. This is most common.
• Abductor spasmodic dysphonia is caused by the vocal cords opening suddenly, which causes the voice to become weak and breathy.

What are the causes?

This condition is caused by muscle spasms of the vocal cords. The cause of muscle spasms is not known. Spasms may be caused by a disruption of certain brain signals that help to control the vocal cords.

What increases the risk?

This condition is most likely to develop in:

• Women.
• People between the ages of 30 and 50.

What are the signs or symptoms?

This condition may cause difficulty speaking, and the voice may stop suddenly. The voice may sound:

• Tight, forced, or strained.
• Jerky or quivery.
• Soft or breathy.
• Hoarse.
• Like groaning.

Symptoms may:

• Come and go.
• Get worse over time.
• Get worse during times of stress or fatigue.
• Go away when you sing or whisper instead of talk.

How is this diagnosed?

This condition may be diagnosed based on:

• Your symptoms.
• Your medical history.
• Laryngoscopy. This is a procedure used to look at the back of your throat, vocal cords, and voice box. A laryngoscopy may be done by inserting one of the following into your throat:
  • A small mirror (indirect laryngoscopy).
  • A thin tube (laryngoscope) with a camera at the end (fiber optic laryngoscopy).
  • A laryngoscope with a type of light at the end that lets your health care provider see how your vocal cords vibrate (stroboscopy).

You may be referred to a health care provider who specializes in the brain and nerves (neurologist), the voice (speech pathologist), or the ears, nose, and throat (otolaryngologist or ENT specialist).

How is this treated?

There is no cure for this condition, but treatment can help improve symptoms. Treatment options may include:

• Injections of a substance (botulinum toxin) into the vocal cords. This can help relax the vocal cords so that they vibrate more smoothly. This is usually effective for 2–3 months at a time.
• Speech therapy. This means that you work with a speech therapist to learn voice and breathing exercises. You may be taught to use a device to make your voice louder and clearer (voice amplification).
• Surgery to replace a nerve that supplies your vocal cords.
• Medicines to help stop the spasms.
• Counseling or support groups.
• Hypnosis.
• Acupuncture.

Follow these instructions at home:

• Rest your voice as told by your health care provider.
• If you work with a speech therapist, practice your exercises as instructed.
• Limit how much alcohol and caffeine you drink.
• Try to avoid stress, and get plenty of rest.
• Do not smoke. Avoid secondhand smoke.
• Take over-the-counter and prescription medicines only as told by your health care provider.
• Keep all follow-up visits as told by your health care provider. This is important.

Contact a health care provider if:

• You have a change in your voice that lasts for more than 2 weeks.
• Your symptoms get worse.
• You have a cough or throat pain that does not go away.
• You have a fever.

Get help right away if:

• You have difficulty breathing.