Spasmodic Dysphonia: Causes, Symptoms and Treatment

November 12, 2012

Spasmodic Dysphonia: Causes, Symptoms and Treatment

Spasmodic dysphonia can greatly impair someone’s ability to talk. There are three types, but they all greatly impair speech. Muscles in the voice box (larynx) go into unpredictable spasms (dystonia.) Since it is caused by a malfunction of the nerves, patients need a neurologist or an ear, eye and throat specialist rather than relying on a general practitioner.

The National Spasmodic Dysphonia Association (NSDA) estimates that about 50,000 people suffer from this neurological condition in North America alone. NSDA notes that many people may refuse to go see a doctor about their problem and thus go undiagnosed. The average patient with spasmodic dysphonia is a woman at least 35 years old. This condition is incurable.

Causes

It is known that muscle spasms of the larynx cause great difficulty in a person talking. But what causes the muscle spasms is unknown, although the NSDA notes that the problem seems to originate at the base of the brain. This area, called the basal ganglia, is known to preside over voluntary movements in the body, such as speech.

But what causes malfunctions of the basal ganglia are still unknown. Since spasmodic dysphonia runs in families, there may be a genetic cause. However, not everyone suffering from this condition is related to someone else with the condition. There are some theories that symptoms began after a blow to the head or recovering from a serious illness, but so far there is no concrete evidence to show any illness as being a cause.

Symptoms

People suffering from spasmodic dysphonia have bizarre, distorted or extremely soft voices that make spoken words hard for any listener to comprehend. The voice may sound as if the speaker is being strangles or has something caught in his throat. Some patients may only be able to whisper. Other patients may be able to pronounce some sounds but not others.

Sometimes people also suffer from muscle problems such as writer’s cramp, involuntary blinking or uncontrollable facial tics. Other patients cannot speak normally but can laugh or sing. Symptoms get worse over time. Some patients may suddenly have all symptoms stop but this only lasts for a short time and symptoms inevitably return.

Treatment

Treatment for spasmodic dysphonia is often problematical at best. Some neurologists recommend combining speech therapy with medications. Medications include injections of Botulinum toxin (commonly called Botox) and pills such as muscle relaxants and anti-anxiety medications like alprazolam (brand name Xanax) or diazepam (brand name Valium.)

In worse case scenarios, the patient may need surgery to cut one nerve to the larynx. Another type of surgery cuts the exact muscle that suffers uncontrollable spasms. However, this surgery has a low success rate.

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