• Spasmodic Dysphonia

    (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. It occurs when 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.
    Main types of SD include:
    • Adductor spasmodic dysphonia—spasms cause muscles to stiffen and close
    • Abductor spasmodic dysphonia—spasms cause muscles to spastically open
    • Mixed spasmodic dysphonia
    Throat
    Throat
    Spasmodic dysphonia affects the throat muscles.
    Copyright © Nucleus Medical Media, Inc.

    Causes

    The exact causes of SD are unknown. It is labeled as a disorder of the central nervous system. The areas of the brain that control these muscle movements are deep within the brain.

    Risk Factors

    Factors increase your chance of developing SD include:
    • Degenerative brain diseases (eg, amyotrophic lateral sclerosis )
    • Another movement disorder (eg, tardive dyskinesia )
    • Family history of SD—In some families, a gene on chromosome 9 may be connected to SD.
    • Brain infection (eg, encephalitis )
    • Exposure to toxins or certain medications (eg, phenothiazines)
    • Gender: female
    • Age: between 30-50 (typical age group when the first signs appear)

    Symptoms

    If you have any of these symptoms do not assume it is due to SD. These symptoms may be caused by other conditions. Contact your doctor if you have any of these:
    • Squeaky, strained speech
    • No speech at all
    • Speech with the wrong pitch and tone
    • Breaks in speech
    • Breathy voice

    Diagnosis

    Your doctor will ask about your symptoms and medical history. A physical exam will be done. Tests may include:
    • Blood and urine tests to find toxins
    • DNA testing for related genes
    • MRI scan —a test that uses magnetic waves to make pictures of structures inside the brain
    • CT scan —a type of x-ray that uses a computer to make pictures of structures inside the brain
    Your doctor may refer you to a team of specialists, including:
    • Neurologist—to evaluate your brain function
    • Speech pathologist—to evaluate your speech and how it’s produced
    • Otolaryngologist—to evaluate your vocal cords

    Treatment

    Talk with your doctor about the best treatment plan for you. Treatment options include the following:
    • Local injections of botulinum toxin (Botox)—to weaken and calm the muscles
    • Medication—to increase dopamine, a chemical in the brain that influences muscle movement
    • Speech therapy techniques—to relax muscles
    • Brain stimulation—to prevent muscles from freezing and going into spasm
    • Counseling—to help deal with the condition
    • Surgery (in severe cases)—to cut or remove nerves connected to the vocal cords

    Prevention

    Since the causes are unknown, it is difficult to prevent SD. Talk to your doctor if you have any of the risk factors.

    RESOURCES

    American Speech-Language-Hearing Association http://www.asha.org/

    National Spasmodic Dysphonia Association http://www.dysphonia.org/

    CANADIAN RESOURCES

    Canadian Association of Speech Language Pathologists http://www.caslpa.ca/

    Ontario Association for Speech-Language Pathologists and Audiologists http://www.osla.on.ca/

    References

    Daniilidou, P, Carding P, Wilson, J, Drinnan, M, Deary, V. Cognitive behavioral therapy for functional dysphonia. Annals of Otology, Rhinology & Laryngology. 2007;116:717-722.

    Diagnosis. National Spasmodic Dysphonia Association website. Available at: http://www.dysphonia.org/spasmodic/diagnosis.asp . Accessed September 8, 2012.

    Dysphonia. EBSCO DynaMed website. Available at: http://www.ebscohost.com/dynamed/what.php . Updated April 30, 2012. Accessed September 8, 2012.

    Spasmodic dysphonia. American Speech-Language-Hearing Association website. Available at: http://www.asha.org/public/speech/disorders/SpasmodicDysphonia.htm . Accessed September 8, 2012.

    Spasmodic dysphonia. EBSCO Publishing Nursing Reference Center website. Available at: http://www.ebscohost.com/pointOfCare/nrc-about . Updated April 30, 2012. Accessed September 8, 2012.

    Spasmodic dysphonia. National Institute on Deafness and Other Communicative Disorders website. Available at: http://www.nidcd.nih.gov/health/voice/Pages/spasdysp.aspx . Accessed September 8, 2012.

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