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
    Spasmodic dysphonia affects the throat muscles.
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  • Causes

    Often, the exact cause of SD is unknown. It is 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 that may increase your chance of developing SD include:
    • Degenerative brain diseases such as amyotrophic lateral sclerosis
    • Another movement disorder such as tardive dyskinesia
    • Family history of SD—In some families, a gene on chromosome 9 may be connected to SD.
    • Brain infection such as encephalitis
    • Exposure to toxins or certain medications such as phenothiazines
    • Gender: female
    • Age: between 30-50
  • Symptoms

    Symptoms of SD include:
    • Squeaky, strained speech
    • No speech at all
    • Speech with the wrong pitch and tone
    • Breaks in speech
    • Breathy voice
  • Diagnosis

    You will be asked about your symptoms and medical history. A physical exam will be done.
    Images may be taken of your bodily structures. This can be done with:
    You may be referred 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:
    • Medication—to increase dopamine, a chemical in the brain that influences muscle movement
    • Botulinum toxin injections—to reduce muscle spasms
    • 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 a nerve that is connected to the vocal cords
  • Prevention

    Since the causes are unknown, it is difficult to prevent SD.

    American Speech-Language-Hearing Association

    National Spasmodic Dysphonia Association


    Ontario Association for Speech-Language Pathologists and Audiologists

    Speech-Language & Audiology Canada


    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: Accessed February 17, 2014.

    Rosow DE, Parikh P, et al. Considerations for initial dosing of botulinum toxin in treatment of adductor spasmodic dysphonia. Otolaryngol Head Neck Surg. 2013; 148(6):1003-6.

    Spasmodic dysphonia. American Speech-Language-Hearing Association website. Available at: Accessed February 17, 2014.

    Spasmodic dysphonia. National Institute on Deafness and Other Communicative Disorders website. Available at: Updated October 2010. Accessed February 17, 2014.

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