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

Throat

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:

• Degenerative 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
• Certain medicines, such as phenothiazines
• Extensive voice use

Symptoms

Problems may be:

• 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 your symptoms and health history. A physical exam will be done.

Images may be taken. This can be done with:

• MRI scan
• CT scan

You may be referred to a team of specialists, such as:

• Neurologist—to evaluate your brain function
• Speech pathologist—to evaluate your speech and how it’s produced
• Otolaryngologist—to evaluate your vocal cords

Treatment

There is no cure. 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.