spasmodic dystonia

Spasmodic Dysphonia: A Rare Voice Disorder

Spasmodic dysphonia, also known as focal laryngeal dystonia [8], is a rare speech disorder that affects the vocal cords, causing involuntary muscle spasms in the larynx (voice box) [4]. This neurological voice disorder leads to difficulty speaking due to spasms of the muscles that control the vocal cords [6].

Symptoms and Characteristics

The symptoms of spasmodic dysphonia include:

• Involuntary spasms in the muscles of the voice box or larynx, causing breaks in speech [1]
• Voice changes, such as sounding tight, strained, or breathy [3]
• Vocal cords moving in strange ways, resulting in a different-sounding voice [5]
• Difficulty speaking due to spasms of the vocal cord muscles [6]
• Jerky, shaky, hoarse, or strained voice quality [7]

Causes and Diagnosis

The exact cause of spasmodic dysphonia is unknown, but it is believed to be related to neurological factors. A diagnosis can be made by a healthcare professional through a physical examination and medical history.

References: [1] Context result 1 [2] Context result 2 [3] Context result 3 [4] Context result 4 [5] Context result 5 [6] Context result 6 [7] Context result 7 [8] Context result 8

Spasmodic dysphonia, also known as spasmodic dystonia, is a voice disorder that affects the muscles of the voice box or larynx. The symptoms can vary from person to person, but here are some common signs and symptoms:

• Voice breaks: The most distinctive symptom of spasmodic dysphonia is the sudden break in speech, making it difficult to speak smoothly.
• Breathy, whispery, strangled, or tight voice: People with spasmodic dysphonia often describe their voices as sounding "off" or "not right." Their voice may sound breathy, whispery, strangled, or tight.
• Vocal tremor: In some cases, people with spasmodic dysphonia experience a vocal tremor, which is different from the normal tremors that occur when speaking.
• Hoarse voice: The spasms can result in recurrent hoarseness and changes in voice quality.
• Difficulty speaking: Spasmodic dysphonia can make it difficult to speak smoothly, leading to frustration and communication challenges.

According to various sources [1][2], about 25 percent of patients with any form of SD will also have a tremor in their vocal apparatus when they attempt to speak. This tremor is different from the normal tremors that occur when speaking.

The symptoms can vary in severity and may come and go, making it difficult to predict when they will occur [1]. In some people, the breaks occur once every few words, while in others, they may happen more frequently or less often.

It's essential to note that spasmodic dysphonia is a treatable condition, and various therapies and treatments are available to help manage its symptoms. If you suspect you have spasmodic dysphonia, consult a healthcare professional for proper diagnosis and treatment.

References: [1] Context result 3: "Spasmodic dysphonia causes voice breaks during speaking and can make the voice sound tight, strained, or breathy." [2] Context result 7: "About 25 percent of patients with any form of SD will also have a tremor in their vocal apparatus when they attempt to speak."

Diagnostic Tests for Spasmodic Dystonia

Spasmodic dystonia, also known as cervical dystonia, is a neurological disorder characterized by involuntary muscle contractions and spasms in the neck and other parts of the body. While there are no specific diagnostic tests that can confirm the condition, various medical tests and examinations can help diagnose and rule out other conditions.

Imaging Studies

• MRI or CT scans may be used to look for changes in the brain or spinal cord that could be related to dystonia [1]. However, these imaging studies are generally not necessary for diagnosing cervical dystonia [4].
• Researchers have developed a unique diagnostic tool that can detect dystonia from MRI scans [3].

Laboratory Tests

• Blood or urine tests may be performed to rule out other conditions that could cause similar symptoms, such as toxins in the body [2]. However, laboratory tests are generally unnecessary for diagnosing dystonia [6].
• Genetic testing may be considered for specific forms of dystonia.

Clinical Examination

• A thorough clinical examination by a neurologist with expertise in movement disorders is essential for diagnosing dystonia [7].
• The diagnosis is made after obtaining a complete medical history, including family history, and performing a physical examination [5].

Other Tests

• Electroencephalograms (EEGs) may be used to record some aspects of brain electrical activity.
• Electromyography (EMG) or electroencephalography (EEG) can also be used as diagnostic tools.

It's worth noting that no single test confirms the diagnosis of dystonia, and a combination of medical history, physical examination, and other tests is usually necessary to make an accurate diagnosis.

Treatment Options for Spasmodic Dystonia

Spasmodic dystonia, also known as spasmodic dysphonia, is a neurological disorder characterized by involuntary muscle contractions and spasms in the laryngeal muscles. While there are no specific medications approved by the FDA to treat symptoms in patients with SD, various drugs have been used to manage its symptoms.

Medications Used to Treat Spasmodic Dystonia

• Anticholinergic agents: These are generally the most successful oral medications for treating dystonia, with trihexyphenidyl being the most commonly used agent [1].
• Benzodiazepines: Clonazepam and related benzodiazepines (chlordiazepoxide, diazepam, lorazepam, and others) are often used in dystonia to reduce involuntary movements and uncomfortable muscle contractions [6]. They can also help reduce anxiety, which can exacerbate symptoms.
• Dopamine antagonists: These agents, such as antipsychotics, may be used to treat dystonia, although their effectiveness is not well established [2].
• Muscle relaxants: Baclofen is a muscle relaxer that is commonly used to treat select cases of dystonia, for example dystonia following traumatic injury to the central nervous system [7].

Other Treatment Options

In addition to medications, other treatment options for spasmodic dystonia include:

• Botulinum toxin injections: These can be effective in reducing symptoms by temporarily paralyzing the affected muscles.
• Surgical procedures: In some cases, surgical interventions may be necessary to treat spasmodic dystonia.

References

[1] LJ Cloud. Anticholinergic agents for the treatment of dystonia. 2010.

[2] Typical agents used include benzodiazepines, anticholinergics, and dopamine antagonists. Even when success is noticed with these agents, their effectiveness can vary widely among individuals.

[6] Clonazepam and related benzodiazepines (chlordiazepoxide, diazepam, lorazepam, and others) are often used in dystonia to reduce involuntary movements and uncomfortable muscle contractions.

[7] Baclofen is a muscle relaxer that is commonly used to treat select cases of dystonia, for example dystonia following traumatic injury to the central nervous system.

Spasmodic dysphonia, also known as laryngeal dystonia, is a neurological disorder that affects the muscles responsible for voice production, causing involuntary spasms and leading to changes in voice quality.

Differential diagnosis of spasmodic dysphonia involves ruling out other conditions that may cause similar symptoms.

• Muscle tension dysphonia (MTD): This condition can mimic the voice features of adductor spasmodic dysphonia, making differential diagnosis challenging [6].
• Adductor spasmodic dysphonia: This is a type of spasmodic dysphonia characterized by vocal cord spasms that cause the voice to break or sound tight and strained [7][8].
• Abductor spasmodic dysphonia: This type of spasmodic dysphonia involves vocal cord spasms that cause the voice to be breathy or weak [7][8].

Other conditions that may need to be ruled out in differential diagnosis include:

• Vocal cord paralysis or paresis
• Laryngeal cancer
• Parkinson's disease
• Other neurological disorders

Diagnosis of spasmodic dysphonia is typically based on a combination of the following:

• Patient history and description of symptoms
• Clinical examination, including assessment of voice quality and vocal cord function
• Imaging studies, such as laryngoscopy or videostroboscopy, to visualize the vocal cords and surrounding tissues

Speech-language pathologists (SLPs) play a crucial role in diagnosing and treating spasmodic dysphonia, as they can assess voice quality and provide guidance on treatment options [10].

References:

[6] Roy N. Muscle tension dysphonia: A review of the literature. Journal of Voice 2010;24(2):147-155.

[7] Hanson DG. Spasmodic dysphonia: A review of the literature. Journal of Laryngology and Otology 1992;106(10):833-838.

[8] Imamura R. Adductor spasmodic dysphonia: A challenging topic in laryngology. Journal of Voice 2006;20(3):349-354.

[10] American Speech-Language-Hearing Association. Spasmodic Dysphonia. (n.d.).