How do Symptoms Change or What is Spasmodic Dysphonia? Progress Over Time? Spasmodic dysphonia (also known as laryngeal Spasmodic Individuals with spasmodic dysphonia may first ) is a movement disorder featuring Dysphonia /Laryngeal notice hoarseness or a “sore throat” that does not involuntary contractions of the vocal cord Dystonia go away. Symptoms can then evolve over a relativel y muscles. These contractions may either result brief period of time before stabilizing. in patterned “breaks” or interruptions in speech , DYSTONIA OF THE or may give a breathy quality to the voice. Most cases of spasmodic dysphonia occur in Most cases of spasmodic dysphonia develop isolation, meaning that the is the only organ in adults. To learn more about dystonia affected by dystonia. However, for other patient s, and the DMRF, contact: dystonia may eventually involve different areas, including the eyelids (blepharospasm), the jaw What are the Symptoms? Dystonia Medical (oromandibular dystonia), or the neck (cervical The voice may sound raspy and strangled, or Research Foundation dystonia). It may also occur in the context of breathy and whispery, depending on which One East Wacker Drive, Suite 1730 childhood-onset generalized dystonia, which laryngeal muscles are involved. It may take added Chicago, Illinois 60601-1905 affects multiple body parts including the limbs. effort to speak, but the voice may improve when Phone: 312-755-0198 whispering, laughing, or singing. Symptoms may Toll free: 800-377-DYST (3978) What is the Cause? vary during the day, become aggravated by certain Email: [email protected] Researchers are investigating possible triggers of speaking tasks—such as talking on the phone— Web: www.dystonia-foundation.org spasmodic dysphonia, including genetic factors. or increase during stressful situations. Symptoms Some genes that predispose patients to develop may improve after sleeping or after consuming Connect with the DMRF on Facebook, spasmodic dysphonia have already been identified , alcohol. Twitter, and YouTube and about 12% of individuals with spasmodic Special thanks to Andres Deik, MD dysphonia have a positive family history. Although spasmodic dysphonia may appear at any for reviewing the content of this brochure. time during adulthood (and even in adolescence), It is possible that trauma can also trigger symptoms most commonly start in people between spasmodic dysphonia either at the time of 40 –50 years old. intubation, for example during surgery, or due to injuries to the neck. Infection or inflammation may also have a role in precipitating this disease.

Experts believe spasmodic dysphonia is the result of excessive signals arising from the brain that cause the vocal cord muscles to contract inappropriately. However, the exact reason why the brain delivers these excessive signals is not completely understood.

© Dystonia Medical Research Foundation 2016 Are There Different Types? What Treatments are Available? In the most refractory of cases of adductor What Kind of Doctor Treats There are several forms of spasmodic dysphonia. Individuals with spasmodic dysphonia may learn laryngeal dystonia, a surgical procedure called Spasmodic Dysphonia? These are classified as: compensatory habits, or tricks, to make speaking selective laryngeal adduction denervation and The diagnosis of spasmodic dysphonia may easier. For example, someone with adductor reinnervation (SLAD/R) may be an option. be made by a speech-language pathologist, Ad ductor spasmodic dysphonia: This form is spasmodic dysphonia that has a very strained, Botulinum neurotoxin injections may still be otolaryngologist (i.e. ear, nose, and throat the most common. The muscles that bring the choked-sounding voice may find that symptoms needed following the surgery, and the procedure’s specialist), and/or neurologist with training vocal cords together contract involuntarily and are reduced by whispering. The whispery voice benefits may not be permanent. in movement disorders. Ongoing treatment excessively during speech. This causes a tight, may initially sound like the less common, abductor may require consultations with multiple strangled-sounding voice quality, often with form because of how the individual is trying to How is This Going to Affect My Daily Life? specialties. For example, a neurologist or abrupt starting and stopping of the voice resulting control the symptoms. Humming before speaking Living well with spasmodic dysphonia is possible. otolaryngologist may administer botulinum in a broken speech pattern. or breathing techniques may also be helpful. The early stages of onset, diagnosis, and seeking neurotoxin injections while a speech-language effective treatment are often the most challenging. pathologist conducts . Ab ductor spasmodic dysphonia: In this form, For patients whose symptoms persist and require The symptoms may vary from mild to severe, the muscles that separate the vocal cords contract treatment, botulinum neurotoxin injections are and symptoms often fluctuate from day to day. What Support is Available? involuntarily, causing them to be held apart, and generally recommended. Although a medication Fatigue is common due to the exertion required The Dystonia Medical Research Foundation resulting in a breathy, whispering voice. with the word “toxin” in it may seem unsettling, to speak. Individuals may have to learn new ways (DMRF) can provide educational resources, botulinum neurotoxin injections have decades of to accomplish daily tasks, particularly those self-help opportunities, contact with others Adductor breathing spasmodic dysphonia: research and clinical experience demonstrating requiring the voice. living with spasmodic dysphonia, volunteer Also called respiratory dystonia , this rare condition that they are safe and the most effective therapy opportunities, and connection to the greater affects the muscles that bring the vocal cords together . available. Botulinum neurotoxin has been approved Individuals living with spasmodic dysphonia are dystonia community. However, instead of contracting during speech (like for clinical use in the United States since 1989 strongly encouraged to: in adductor spasmodic dysphonia described above), and has improved the lives of countless individuals • Seek out the best medical care. What is the DMRF? the muscles do so during breathing. Theses with dystonia. • Learn about spasmodic dysphonia and The Dystonia Medical Research Foundation create noisy and labored breathing. Individuals may treatment options. (DMRF) is a 501(c)3 non-profit organization also experience trouble swallowing due to difficulty Speech/voice therapy is often incorporated into • Develop a multi-layered support system of that has served the dystonia community since breathing while eating. the treatment plan, especially before and after support groups, online resources, friends, family, 1976. The DMRF funds medical research toward botulinum neurotoxin injections. Voice therapy and mental health professionals, if needed. a cure, promotes awareness and education, and A combination of the above: Some individuals can help the fatigue associated with the added • Investigate complementary therapies. supports the well being of affected individuals have symptoms that resemble more than one effort required to speak. Techniques that focus on • Get active within the spasmodic dysphonia and families. classification of spasmodic dysphonia. Others controlling the breath and using the breath to make and dystonia community. may have a voice and/or tremor affecting the most of the voice may be surprisingly helpful. The DMRF can put you in touch with others adjacent areas. Weeks or months of voice therapy may be required. with dystonia for networking and support.

Oral medications may also be tried but are rarely as effective as injections, and are not without side effects.