Understanding Spasmodic Dysphonia

Spasmodic dysphonia is a voice disorder that prevents a person from speaking clearly. Often, when one sounds awful and strains to get words out, people think the person has a terrible cold. This disorder makes telephone conversations an ordeal, and one can easily feel isolated and misunderstood.


Although a rare disorder, spasmodic dysphonia can affect anyone. The first signs of spasmodic dysphonia are found most often in people between 30 and 50 years of age, affecting women more than men.


Neurologically, spasmodic dysphonia is a disorder affecting the voice muscles in the larynx or voice box. When we speak, air from the lungs is pushed between two elastic structures - called vocal folds or vocal cords - with sufficient pressure to cause them to vibrate, producing sound. In spasmodic dysphonia, the muscles inside the vocal folds experience sudden involuntary movements, called spasms, which interfere with the ability of the folds to vibrate and produce the intended sound.


Spasmodic dysphonia causes voice breaks and can give the voice a tight, strained quality. At first, symptoms may be mild and occur only occasionally, but they can worsen and become more frequent over time. Spasmodic dysphonia is a chronic condition that continues throughout a person’s life.


Dr. Naomi Lubarr, a neurologist at The Bachmann-Strauss Dystonia Center of Excellence at Beth Israel Medical Center, explains, “Major concerns for patients with spasmodic dysphonia are the difficulties they have with communication due to the alteration in their voice and speech, and how their impaired voice affects their work life, social life, and family life.”


Continuing, Dr. Lubarr’s advice for coping is to seek the best medical treatment possible, based on each patient’s specific condition and needs. Treatment options include botulinum toxin injections by an experienced ear, nose and throat doctor, and speech therapy. However, paying attention to and treating other aspects of a patient’s overall condition are important, including any associated depression or anxiety.


Dr. Lubarr suggested that limiting voice use when possible, using email or writing notes, exercises as directed by a speech therapist when public speaking is necessary, and expression through other means, such as with a musical instrument, are great too.