How do Symptoms Change Over Time? Individuals with may What is Spasmodic Dysphonia? first notice hoarseness or a sore throat that Spasmodic dysphonia (also known does not improve. Symptoms may worsen as laryngeal ) is a movement Spasmodic over a relatively brief period of time before dis order featuring involuntary contrac - Dysphonia stabilizing. tions of the vocal cord muscles. These contractions may result in patterned DYSTONIA OF THE Most cases of spasmodic dysphonia occur “breaks” or interruptions in , or in isolation, meaning that the is the may give a breathy quality to the voice. To learn more about dystonia only muscle affected by dystonia. However, Most cases of spasmodic dysphonia and the DMRF, contact: in some cases, dystonia may eventually in - develop in adults. volve different areas including the eyelids Dystonia Medical (blepharospasm), the jaw (oromandibular Research Foundation dystonia), or the neck (cervical dystonia). One East Wacker Drive, Suite 1730 What are the Symptoms? It may also occur as part of childhood- Chicago, Illinois 60601-1980 The voice may sound raspy and strangled, or onset generalized dystonia, which affects Phone: 312-755-0198 breathy and whispery, depending on which the body and limbs. Toll free: 800-377-DYST (3978) laryngeal muscles are involved. It may take Email: [email protected] What is the Cause? added effort to speak, but the voice may Web: www.dystonia-foundation.org Researchers are investigating possible triggers improve when whispering, laughing, or Connect with the DMRF on Facebook, of spasmodic dysphonia. Several genes that . Symptoms may vary during the Twitter, and YouTube. predispose patients to spasmodic dysphonia day, become aggravated by certain speaking have been identified, and about 12% of tasks—such as talking on the phone—or Special thanks to Andres Deik, MD individuals with spasmodic dysphonia increase during stressful situations. Symptoms for reviewing the content of this brochure. have a positive family history. may improve after sleeping or after consum - ing alcohol. Injury to the larynx or neck area may trigger spasmodic dysphonia. Infection Although spasmodic dysphonia may appear or inflammation may also have a role in at any time during adulthood (and even in precipitating this disease. Experts believe adolescence), symptoms most commonly spasmodic dysphonia is the result of excessiv e start in people between 40 –50 years old. signals arising from the brain that cause the vocal cord muscles to contract inappropri - ately. However, why the brain delivers these excessive signals is not completely understood.

© Dystonia Medical Research Foundation 2017 Are There Different Types? What Treatments are Available? Oral medications may also be tried but are What Kind of Doctor Treats There are several forms of spasmodic dysphonia . Individuals with spasmodic dysphonia may rarely as effective as injections, and are not Spasmodic Dysphonia? These are classified as: learn compensatory habits, or tricks, to make without side effects. In the most refractory The diagnosis of spasmodic dysphonia speaking easier. For example, someone with of cases of adductor laryngeal dystonia, a may be made by a speech-language pathol - Ad ductor spasmodic dysphonia: This form is adductor spasmodic dysphonia that has a very surgical procedure called selective laryngeal ogist, otolaryngologist (i.e. ear, nose, and the most common. The muscles that bring the strained, choked-sounding voice may find adduction denervation and reinnervation throat specialist), and/or neurologist with vocal cords together contract involuntarily and that symptoms are reduced by whispering. (SLAD/R) may be an option. Botulinum training in movement disorders. Ongoing excessively during speech. This causes a tight, The whispery voice may initially sound like neurotoxin injections may still be needed treatment may require consulta tions with strangled-sounding voice quality, often with the less common, abductor form because of following the surgery, and the procedure’s multiple specialties. For example , a neurol - abrupt starting and stopping of the voice how the individual is trying to control the benefits may not be permanent. ogist or otolaryngologist may administer resulting in a broken speech pattern. symptoms. Humming before speaking or botulinum neurotoxin injections while a breathing techniques may also be helpful. How is This Going to Affect My speech-language pathologist conducts Ab ductor spasmodic dysphonia: In this Daily Life? . form, the muscles that separate the vocal cords For patients whose symptoms persist and Living well with spasmodic dysphonia is contract involuntarily, causing them to be held require treatment, botulinum neurotoxin possible. The early stages of onset, diagnosis, What Support is Available? apart, and resulting in a breathy, whispering injections are generally recommended. and seeking effective treatment are often the The Dystonia Medical Research Foundation voice. Although a medication with the word “toxin” most challenging. The symptoms may vary (DMRF) can provide educational resources , in it may seem confusing, botulinum neuro - from mild to severe, and symptoms often self-help opportunities, contact with others Adductor breathing spasmodic dysphonia: toxin injections have decades of research and fluctuate from day to day. Fatigue is common living with spasmodic dysphonia, volunteer Also called respiratory dystonia , this rare clinical experience demonstrating that they are due to the exertion required to speak. Individ - opportunities, and connection to the condition affects the muscles that bring the safe and the most effective therapy available. uals may have to learn new ways to accomplish greater dystonia community. vocal cords together. However, instead of Botulinum neurotoxin has been approved for daily tasks, particularly those requiring contracting during speech (like in adductor clinical use in the United States since 1989 the voice. What is the DMRF? spasmodic dysphonia described above), the and has improved the lives of countless The Dystonia Medical Research Foundation muscles do so during breathing. Theses individuals with spasmodic dysphonia and Individuals living with spasmodic dysphonia (DMRF) is a 501(c)3 non-profit organiza - create noisy and labored breathing. Individuals other types of dystonia. are strongly encouraged to: tion that has served the dystonia communit y may also experience trouble swallowing due to • Seek out the best medical care. since 1976. The DMRF funds medical difficulty breathing while eating. Speech/voice therapy is often incorporated • Learn about spasmodic dysphonia and research toward a cure, promotes awareness into the treatment plan, especially before and treatment options. and education, and supports the well bein g A combination of the above: Some individual s after botulinum neurotoxin injections. Voice • Develop a multi-layered support system of affected individuals and families. have symptoms that resemble more than one therapy can address the fatigue associated with of support groups, online resources, friends, classification of spasmodic dysphonia. Others the added effort required to speak. Techniques family, and mental health professionals, The DMRF can put you in touch with may have a voice and/or tremor that focus on controlling the breath and using if needed. others with dystonia for networking and affecting adjacent areas. the breath to make the most of the voice may • Investigate complementary therapies. support. be surprisingly helpful. Weeks or months of • Get active within the spasmodic dysphonia voice therapy may be required. and dystonia community.