DOCSLIB.ORG

What Is Spasmodic Dysphonia? What Causes Spasmodic Types of Dystonia, E.G

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
What Is Spasmodic Dysphonia? What Causes Spasmodic Types of Dystonia, E.G What are the side effects? References: There may be some temporary Dystonia Medical Research Foundation side effects. The most common are (USA) weakness/hoarseness of voice, which National Spasmodic Dysphonia may last up to two weeks and some Association (USA) difficulty with swallowing, which normally only lasts for 2-3 days. The aim The Dystonia Society (U.K) is to keep a balance between smoothing out the voice spasm, and not weakening the voice or the swallowing muscles too much. Some people do not suffer any side effects at all. People rarely feel ill following a botox injection. How is the injection given? The injection is performed by a trained ENT doctor in the outpatients department of the hospital. The The Trust provides free injection takes only a few minutes What is monthly health talks on a to administer, and is monitored by variety of medical conditions electromyography (EMG) to ensure and treatments. For more information visit Spasmodic correct placement of the needle. The www.uhb.nhs.uk/health-talks.htm needle is inserted through the front of Dysphonia? the neck and into the vocal folds. Patients are usually able to carry on normally afterwards but must be aware Speech and Language Therapy of swallowing difficulties should they Department occur. Advice on how to manage side Queen Elizabeth Hospital Birmingham effects will be provided at the clinic. Mindelsohn Way, Edgbaston UHB is a no smoking Trust We provide all patients undergoing the Birmingham B15 2GW procedure with simple record forms to Telephone: (0121) 371 3483 To see all of our current complete; this enables us to monitor patient information leaflets please visit the outcome of the injection and plan PI18/1433/03 Author: Speech and Language Therapy and ENT Departments www.uhb.nhs.uk/patient-information-leaflets.htm further treatment. Date: September 2018 Review date: September 2020 What is spasmodic dysphonia? What causes spasmodic types of dystonia, e.g. blepharospasm (excessive eye blinking) but in most Spasmodic dysphonia (SD) is also known dysphonia? cases the problem remains in the voice as laryngeal dystonia. (It sometimes Most of the time, the cause of spasmodic box as a ’focal dystonia’. used to be called spastic dysphonia.) dysphonia is unknown. In some cases it It is a neurological condition, affecting appears the onset is caused by trauma the vocal muscles of the larynx (voice to the vocal folds, or sometimes people What is the treatment for SD? box). relate it to a stressful event. Regardless of the cause, the symptoms of SD Since the underlying cause is unknown Symptoms may improve or disappear are thought to be due to abnormal there is no cure for the condition. when yawning, laughing, singing or functioning in an area of the brain Sometimes voice therapy helps as relaxing. called the basal ganglia. This is part patients benefit from relaxation and Spasmodic dysphonia may be of the brain that helps us co-ordinate exercises to prevent their throat from aggravated by certain tasks such as movements through our bodies. The tightening up. Patients also benefit continual use of the telephone. Stress general medical consensus is that SD is a from the extra control voice therapy sometimes makes the symptoms worse central nervous system disorder. gives them. Certain medications can too, but it is not the cause. help to relieve symptoms in some people. When can it start? What are the different types It can start at any time of life, but it of spasmodic dysphonia? occurs more often in the 40-50 years Botulinum toxin injections There are two main types of voice age group and is slightly more common (Botox) problems: in women. A genetic factor is suspected Local injection of botulinum toxin into in some patients as other family In the more common adductor type, the vocal fold muscles has been found members may have signs of dystonia there is a spasm in the muscles of the to be effective in treating SD. This is involving some other part of the body. vocal folds when they move together. being used in quite a few centres in this The voice then has a strangled, strained, country now, to improve voice quality. choked quality, often with problems It works by weakening the muscles, of speech breaking up unintentionally. How is it diagnosed? and so reducing the spasm in the vocal Talking is an effort. SD is a rare condition and is often folds. In the larynx it is given in very In the abductor type, the over- confused with vocal abuse or vocal small diluted quantities, and lasts for contraction in the muscles happens as strain. Because there is no definite test 6-8 weeks or more. The botox is not the vocal folds separate resulting in for SD, the diagnosis rests on certain a cure, but injections can be repeated a choppy, breathy, whispering voice clinical symptoms being present. regularly according to individual need pattern. Occasionally patients may have other and resources available..
Load more

Recommended publications
  • Plain Language Summary: Hoarseness
    Guidelines Plain Language Summary Otolaryngology– Head and Neck Surgery 2018, Vol. 158(3) 427–431 Plain Language Summary: Hoarseness Ó American Academy of Otolaryngology—Head and Neck (Dysphonia) Surgery Foundation 2018 Reprints and permission: sagepub.com/journalsPermissions.nav DOI: 10.1177/0194599817751137 http://otojournal.org Helene J. Krouse, PhD, RN1, Charles (Charlie) W. Reavis2, Robert J. Stachler, MD3,4, David O. Francis, MD, MS5, and Sarah O’Connor6 Sponsorships or competing interests that may be relevant to content are dis- pulmonology, and speech-language pathology. The group also closed at the end of this article. included a staff member from the AAO-HNSF. Prior to publica- tion, the guideline underwent extensive peer review, including open public comment. Abstract This plain language summary for patients serves as an over- What Is Hoarseness (Dysphonia)? view in explaining hoarseness (dysphonia). The summary Dysphonia (pronounced ‘‘diss-foh-nee-uh’’), or impaired applies to patients in all age groups and is based on the 2018 voice production, is sometimes called ‘‘hoarseness.’’ ‘‘Clinical Practice Guideline: Hoarseness (Dysphonia) Dysphonia describes your impaired voice production. (Update).’’ The evidence-based guideline includes research to Hoarseness is a symptom of a change in your voice quality. support more effective identification and management of Health care providers will use the clinical term dysphonia, patients with hoarseness (dysphonia). The primary purpose but patients and the public use the more common term
    [Show full text]
  • Essential Tremor of the Voice Vs. Spasmodic Dysphonia by Michael M
    Essential Tremor (ET) Essential Tremor of the Voice vs. Spasmodic Dysphonia By Michael M. Johns, MD (pictured below)- Director at Emory Voice Center, Emory University, Atlanta, GA and member of the IETF Medical Advisory Board, and Madeleine Pethan, MS, CCC-SLP - Speech Pathologist at Emory Voice Center Introduction box, is not the only structure which can cause essential tremor of the voice. Tremor of the voice can be caused Certain neurologic conditions can cause people to have when any of the structures in the speech system is problems with their voice. These voice problems can affected. Essential tremor of the voice may be caused often lead to more difficulty communicating throughout by tremor in the soft palate, tongue, pharynx, or even daily life. It is important that patients with neurological muscles of respiration. Extralaryngeal tremor (i.e., out- voice disorders are evaluated by an otolaryngologist, or side the voice box) has been reported in up to as many ENT doctor, in addition to their neurologist to determine as 93% of patients with diagnosed essential tremor of the diagnosis and discuss treatment options. Many the voice. Similarly, most patients with essential tremor patients with essential tremor also experience essential of the voice also have tremor affecting their hands, leg, tremor of the voice. Essential tremor of the voice can chin, or trunk. often be confused with another neurologic voice disor- der known as spasmodic dysphonia. Essential tremor seems to be associated with aging, al- though the reasons are still inconclusive. Most studies What is Essential Tremor? report average age of onset from the late 40s to early 50s.
    [Show full text]
  • Clinical Policy: Voice Therapy Reference Number: HNCA.CP.MP.134 Effective Date: 4/10 Coding Implications Last Review Date: 02/21 Revision Log
    Clinical Policy: Voice Therapy Reference Number: HNCA.CP.MP.134 Effective Date: 4/10 Coding Implications Last Review Date: 02/21 Revision Log See Important Reminder at the end of this policy for important regulatory and legal information. Description Voice therapy refers to any non-surgical techniques employed in the management of individuals with voice disorders. The goal is to modify vocal behaviors to reduce or correct maladaptive and inappropriate vocal behaviors and laryngeal trauma. Voice therapy is usually subject to speech therapy benefits. Policy/Criteria I. It is the policy of Health Net of California that voice therapy is medically necessary when provided by a qualified speech language pathologist for the following indications: A. Post vocal cord surgery or vocal cord trauma, or B. Post laryngeal (glottic) carcinoma, or C. Paradoxical vocal cord motion, or D. Functional or spastic (spasmodic) dysphonia, or E. Vocal cord nodules/lesions, or F. Vocal cord paralysis, or G. As part of gender affirming services. II. It is the policy of Health Net of California that voice therapy is not medically necessary to improve voice quality due to such conditions as laryngitis or for occupational or recreational purposes. Background Voice disorders are characterized by pitch, loudness, resonance, quality or duration of voice or by the inability to use one’s voice. The disorders result from abnormal laryngeal, respiratory or vocal tract functioning. Voice therapy includes four major components: vocal hygiene, vocal production, muscle relaxation and respiratory support. Disorders of the vocal cords such as surgical procedures, trauma, cancer, nodules and issues regarding motility (spasm, paralysis) can all affect speech.
    [Show full text]
  • Spastic Dysarthria Vs. Spasmodic Dysphonia
    Spastic Dysarthria vs. Spasmodic Dysphonia Symptoms, Treatment, and Differential Diagnosis Ariella Ruderman & Jasmine Smith Spastic Dysarthria Caused by bilateral damage to UMN Degenerative disease, vascular causes, TBI, unknown Hypertonia, hyperreflexia, spasticity, neuropath. reflexes Speech: slow, effortful, may be hypernasal, imprecise artic., hoarseness, strain-strangle, monopitch/pitch breaks, short phrases, monoloud (Duffy 2005) Spasmodic Dysphonia Cause: probably supranuclear (once thought psychogenic) AD type VF's spasm shut Vocal strain, voice blocks AB type VF's spasm open Breathy voice, aphonic moments Worse during unvoiced consonants TASK SPECIFIC! Symptoms only occur during connected speech Stemple (2000), Finitzo (1989) Diagnosing motor-speech disorders based on voice production and quality Darley, Aronson Brown showed each type of dysarthria manifests “clinically distinguishable auditory-perceptual characteristics.” (Duffy & Kent, 2001) Voice features correspond to physiology (shown by DAB in original tests of validity of their methods but cross- validation using modern imaging techniques in order) Birth of the SLP as diagnostician! Acoustic-perceptual analysis A tool developed by DAB to guide listening to the features of a patient’s speech Created a rating scale: 38 perceptual features (newer examples: GRBAS scale: Grade, Roughness, Breathiness, Asthenia, Strain; CAPE-V: Consensus Auditory Perceptual Evaluation–Voice) Advantages: Requires only a trained ear After some debate has been shown to be effective,
    [Show full text]
  • Research Priorities in Spasmodic Dysphonia
    Otolaryngology–Head and Neck Surgery (2008) 139, 495-505 LITERATURE REVIEW Research priorities in spasmodic dysphonia Christy L. Ludlow, PhD, Charles H. Adler, MD, PhD, Gerald S. Berke, MD, Steven A. Bielamowicz, MD, Andrew Blitzer, MD, DDS, Susan B. Bressman, MD, Mark Hallett, MD, H.A. Jinnah, MD, PhD, Uwe Juergens, PhD, Sandra B. Martin, MS, Joel S. Perlmutter, MD, Christine Sapienza, PhD, Andrew Singleton, PhD, Caroline M. Tanner, MD, PhD, and Gayle E. Woodson, MD, Bethesda and Baltimore, MD; Scottsdale, AZ; Los Angeles and Sunnyvale, CA; Washington, DC; New York, NY; Geottingen, Germany; St Louis, MO; Gainesville, FL; Springfield, IL first year, then becoming chronic.2 SD is usually idiopathic; OBJECTIVE: To identify research priorities to increase under- symptoms rarely occur as a result of brain injury or neuro- standing of the pathogenesis, diagnosis, and improved treatment of leptics. Women are affected more than men; between 60 spasmodic dysphonia. percent and 85 percent female.3,4 STUDY DESIGN AND SETTING: A multidisciplinary working Involuntary spasms in the laryngeal muscles cause group was formed that included both scientists and clinicians from 5 6 multiple disciplines (otolaryngology, neurology, speech pathology, intermittent voice breaks, only during speech. In ad- genetics, and neuroscience) to review currently available information ductor SD, spasmodic hyperadductions of the vocal folds on spasmodic dysphonia and to identify research priorities. produce voice breaks with a choked, strained quality. RESULTS: Operational definitions for spasmodic dysphonia at Abductor SD is less common, with hyperabduction (un- different levels of certainty were recommended for diagnosis and controlled opening) of the vocal folds prolonging voice- recommendations made for a multicenter multidisciplinary validation less consonants before vowels.7 Very rarely, adductor study.
    [Show full text]
  • ORD Resources Report
    Resources and their URL's 12/1/2013 Resource Name: Resource URL: 1 in 9: The Long Island Breast Cancer Action Coalition http://www.1in9.org 11q Research and Resource Group http://www.11qusa.org 1p36 Deletion Support & Awareness http://www.1p36dsa.org 22q11 Ireland http://www.22q11ireland.org 22qcentral.org http://22qcentral.org 2q23.org http://2q23.org/ 4p- Support Group http://www.4p-supportgroup.org/ 4th Angel Mentoring Program http://www.4thangel.org 5p- Society http://www.fivepminus.org A Foundation Building Strength http://www.buildingstrength.org A National Support group for Arthrogryposis Multiplex http://www.avenuesforamc.com Congenita (AVENUES) A Place to Remember http://www.aplacetoremember.com/ Aarons Ohtahara http://www.ohtahara.org/ About Special Kids http://www.aboutspecialkids.org/ AboutFace International http://aboutface.ca/ AboutFace USA http://www.aboutfaceusa.org Accelerate Brain Cancer Cure http://www.abc2.org Accelerated Cure Project for Multiple Sclerosis http://www.acceleratedcure.org Accord Alliance http://www.accordalliance.org/ Achalasia 101 http://achalasia.us/ Acid Maltase Deficiency Association (AMDA) http://www.amda-pompe.org Acoustic Neuroma Association http://anausa.org/ Addison's Disease Self Help Group http://www.addisons.org.uk/ Adenoid Cystic Carcinoma Organization International http://www.accoi.org/ Adenoid Cystic Carcinoma Research Foundation http://www.accrf.org/ Advocacy for Neuroacanthocytosis Patients http://www.naadvocacy.org Advocacy for Patients with Chronic Illness, Inc. http://www.advocacyforpatients.org
    [Show full text]
  • Spasmodic Dysphonia: Description of the Disease and Associated Neurologic Disorders
    Original Article Spasmodic Dysphonia: Description of the Disease and Associated Neurologic Disorders Disfonia Espasmódica: Descrição da Doença e dos Distúrbios Neurológicos Associados Marina Serrato Coelho*, Evaldo Macedo**, Marcela Schmidt Braz de Oliveira***, Paulo Lobo****, Andréa Thomaz Soccol*****, Heloisa Nardi Koerner*. * Resident Physician in the Department of Otorhinolaryngology, HC-UFPR. ** Doctor. Physician in the Department of Otorhinolaryngology, HC-UFPR. *** Intern in the Department of Otorhinolaryngology, HC-UFPR. **** Physician. ***** Otorhinolaryngologist. Instituition: Hospital de Clinicas, Federal University of Parana. Curitiba / PR - Brazil. Mail Address: Marina Serrato Coelho - Rua Francisco Juglair, B 298 301 - Curitiba / PR - Brazil - Zip code: 81200-230 - Telephone: (+55 41) 3360-1800 - E-mail: [email protected] Article received in October 1, 2009. Article accepted in April 21, 2010. SUMMARY Introduction: Spasmodic dysphonia (SD) is a problem that affects speech and vocalization, one of the most devastating disorders of oral communication. It is characterized by vocal quality tensaestrangulada, harshly and / or interspersed with abrupt vocal attack and a great tension in the vocal tract. The etiology of spasmodic dysphonia is unclear. Some authors point to psychogenic causes, neurological or even unknown. Objective: To assess the prevalence of muscular dystonias and other neurological symptoms in patients with ED. Method: A retrospective study of 10 cases with diagnosis of ED for symptoms and neurological disorders associated. Results: There was a significant predominance of the disease in females (9:1). The average age of onset of symptoms was 32 years, ranging between 14 and 60 years. The mean disease duration was 10 years. Among the patients, 87.5% had a diagnosis of disorders of movement made by a neurologist, including orofacial dystonias (50%), essential tremor (50%) and spastic paraparesis (12%).
    [Show full text]
  • Spasmodic Dysphonia and Related Voice Conditions During COVID-19
    What do I need to know having spasmodic dysphonia or a related voice condition during the COVID-19 pandemic? By Christie DeLuca, MS CCC-SLP Speech Language Pathologist, Clinical Voice Specialist You may be in one (or all) of the following situations: Your botulinum toxin (Botox) injection has been cancelled or indefinitely postponed and symptoms are getting more significant; you are being forced to work remotely which means more phone calls and virtual meetings leading to vocal fatigue, a strained voice, and difficulty being heard, having a smooth voice or projecting effectively; you are dealing with more stress and anxiety during this time which is making your voice symptoms worse; you are worried that having spasmodic dysphonia makes you more at risk if you were to develop COVID-19. Let’s hopefully tackle some of these issues with some pertinent information. 1. You are worried that having spasmodic dysphonia makes you more at risk if you were to develop COVID-19 COVID-19 does NOT make you more susceptible to developing COVID-19. Further, if you are to develop COVID-19, having spasmodic dysphonia does not put you at greater risk. Spasmodic dysphonia, tremor and muscle tension dysphonia are not disorders that compromise your airway or respiratory system. Some with spasmodic dysphonia (particularly those with AB, those with AD up to 3 weeks after a botulinum toxin injection) or essential tremor of the voice may experience shortness of breath when speaking. However, this related to the valving of air at the level of your vocal folds and not related to a respiratory disorder.
    [Show full text]
  • 2003 Chhetri Histology of Nerves and Muscles in Adductor Spasmodic
    Ann Otol Rhinal Laryngol 112:2003 HISTOLOGY OFNERVES AND MUSCLES INADDUCTOR SPASMODIC DYSPHONIA DINESH K. CHHETRI, MD JOEL H. BLUMIN, MD LosANGELES, CALIFORNIA PHILADELPHIA, PENNSYLVANIA HARRY V. VINTERS, MD GERALD S. BERKE, MD LosANGELES, CALIFORNIA LosANGELES, CALIFORNIA To elucidate the etiology and pathophysiology ofspasmodic dysphonia, weexamined the adductor branch ofthe recurrent laryn­ geal nerve and the lateral cricoarytenoid muscle from 9 consecutive patients with this disorder who were previously treated with botulinum toxin. Histologic examination revealed average muscle fiber diameters ranging from 21 to5711m. Botulinum toxin treat­ ment-related muscle atrophy was observed up to 5 months after injection. Endomysial fibrosis was present in all samples. His­ tochemical analysis in8patients revealed type 2fiber predominance in7 patients and fiber type grouping in2.Type-specific muscle fiber size changes were notpresent. Nerve samples were examined in plastic sections. In 8 patients the nerves contained homoge­ neous, large-diameter myelinated nerve fibers and sparse small fibers. One patient had a relatively increased proportion of small myelinated nerve fibers. Overall, the nerve fiber diameter was slightly larger inpatients than incontrols. These findings may impli­ cate thecentral nervous system inthepathophysiology of adductor spasmodic dysphonia. KEY WORDS - histology, muscle, nerve, pathophysiology, spasmodic dysphonia. INTRODUCTION Bielamowicz and Ludlow> reported improved EMG The etiology and pathophysiology of spasmodic signals in contralateral thyroarytenoid (TA) muscles dysphonia (SD) remain elusive even after more than after unilateral botulinum toxin (BTX) injection, and a century of discussion in the literature. Spasmodic they hypothesized that a central reduction in moto­ dysphonia is classified into adductor and abductor neuron activity secondary to reduced sensorimotor 6 types based on the laryngeal muscle groups affected.
    [Show full text]
  • Clinical Assessment and Treatment of Individuals with Vocal Tremor (VT)
    Clinical Assessment and Treatment of Individuals with Vocal Tremor (VT) Julie Barkmeier-Kraemer, PhD, CCC-SLP Professor, ASHA-F University of Utah [email protected] Julie Barkmeier-Kraemer, PhD, CCC-SLP, ASHA-F Professor, Otolaryngology – Head and Neck Surgery Clinic Director, Voice Disorders Center Adjunct Faculty, Dept of CSD DISCLOSURES: • Financial: • Affiliate instructor with royalties from MedBridge Inc for my online courses on vocal tremor • NIDCD funds my research on essential tremor and vocal tremor (R01 DC016838) • Non-Financial: • ASHA: Member of SIGs 3, 12, 18 • Member of the NSDA Scientific Advisory Council Presentation Objectives: 1. Identify and describe the updated classification tremor criteria applied to vocal tremor and speech structures, 2. Describe clinical assessment approaches that enable improved differentiation between vocal tremor and laryngeal dystonia, and 3. Summarize treatment options for those with vocal tremor. Differential diagnosis of voice disorders “Spasmodic Dysphonia” Focal Laryngeal Dystonia (Albanese et al, 2013) Hyperkinetic movement disorder affecting 1 body part “Sustained or intermittent muscle contractions causing abnormal, often repetitive, movements, postures, or both.” Associated with onset or worsening specific to volitional speech activity (i.e. task specific) Affects 1 per 100,000 dystonia cases (Nutt, Muenter, Aronson, Kurland, Melton, 1988; Konkiewitz et al, 2002) Less than 8% of those with SD have family members with dystonia (Xiao, Zhao, Bastian, et al, 2010; Hintze et al, 2017) Terminology: Classification is everything 2019: Laryngeal 1971- Dystonia present: (NIDCD Spasmodic workshop) 1959-1997: Dysphonia Spastic Dysphonia Simonyan K, Barkmeier-Kraemer J, Blitzer A, Hallett M, Houde JF, Jacobson Kimberley T, Ozelius LJ, Pitman MJ, Mark Richardson R, Sharma N, Tanner K; NIH/NIDCD Workshop on Research Priorities in Spasmodic Dysphonia/Laryngeal Dystonia.
    [Show full text]
  • A Preliminary Investigation of the Affective, Behavioral and Cognitive
    rde iso rs, D De on a ti f a S c t Vanryckeghem et al., Commun Disord Deaf Stud i u n d u i e m s Journal of Communication Disorders, & Hearing Aids 2015, 3:2 m o H C e f a o r l ISSN: 2375-4427i DOI: 10.4172/2375-4427.1000131 n a g n r A u i d o s J Deaf Studies & Hearing Aids Research Article Open Access A Preliminary Investigation of the Affective, Behavioral and Cognitive Variables Associated with Spasmodic Dysphonia Martine Vanryckeghem* and Bari Hoffman Ruddy Department of Communication Sciences and Disorders, University of Central Florida, Orlando, USA *Corresponding author: Martine Vanryckeghem, Professor, Department of Communication Sciences and Disorders, University of Central Florida, Orlando, USA, Tel: 407-823 4808; E-mail: [email protected] Received date: April 02, 2015, Accepted date: April 20, 2015, Published date: April 25, 2015 Copyright: © 2015 Vanryckeghem M, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Abstract Background: Spasmodic dysphonia (SD) is often assessed and treated in a rather mono-dimensional way, despite knowledge of the impact of SD on a person’s quality of life. This study investigates how adults with SD think and feel about their speech, and cope with their voice problem. Methods: Adults with SD were asked to fill out the Behavior Assessment Battery’s (BAB-Voice) self-report tests. The Speech Situation Checklist-Emotional Reaction and Speech Disruption investigate negative emotional reaction and voice problems in particular speech situations.
    [Show full text]
  • Spasmodic Dysphonia
    U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES ∙ National Institutes of Health NIDCD Fact Sheet | Voice, Speech, and Language Spasmodic Dysphonia What is spasmodic dysphonia? Parts of the throat involved Spasmodic dysphonia, or laryngeal dystonia, is a disorder in spasmodic dysphonia affecting the voice muscles in the larynx, also called the voice box. When you speak, air from your lungs is pushed between two elastic structures—called vocal folds—causing them to vibrate and produce your voice. In spasmodic dysphonia, the muscles inside the vocal folds spasm (make sudden, involuntary movements), interfering with vocal fold vibrations. Spasmodic dysphonia may occur along with other forms of dystonia that cause repeated spasms in other parts of the body, including the eyes, face, jaw, lips, tongue, neck, arms, or legs. Spasmodic dysphonia causes voice breaks during speaking and can make the voice sound tight, strained, or breathy. In some people, the breaks occur once every few sentences. In more severe cases, spasms may occur on every word, making a person’s speech very diffcult to understand. Some people with spasmodic dysphonia may also have vocal tremor—a shaking of the larynx and vocal folds that causes the voice to tremble. Source: NIH/NIDCD Spasmodic dysphonia is a chronic condition that continues throughout a person’s life. Spasmodic dysphonia may develop suddenly, with severe voice symptoms present from What are the types of spasmodic the start of the disorder, or it may start with mild symptoms dysphonia? and occur only occasionally before worsening and becoming } Adductor spasmodic dysphonia is the most more frequent over time.
    [Show full text]