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UR Medicine / Otolaryngology (ENT) / Speech Pathology / Our Services / Spasmodic Dysphonia & Vocal Tremor

 

Spasmodic Dysphonia & Vocal Tremor

What is spasmodic dysphonia?

Spasmodic dysphonia (SD) is a focal DYSTONIA (aberrant muscle movement) that is activated only with speech.   There are two types of SD; aDductor and aBductor SD.  

  • ADductor spasmodic dysphonia causes the vocal fold (cords) to have difficulty opening of letting go of a sound during speech resulting in a strained, strangled sounding voice with breaks.  
  • ABductor spasmodic dysphonia causes difficulty opening the vocal folds which makes it difficult to start the next sound, resulting in a voice with breathy breaks.   
  • Mixed spasmodic dysphonia is when these two types of SD co-occur

What is tremor?

Tremor is an involuntary, rhythmic contraction of a muscle/s that cause the affected parts of the body to shake.  Tremor can be an isolated disorder for example Intention/Essential Tremor or be a symptom of other neurological disorders, for example Parkinson’s Disease.   Tremor can be treated with beta-blocking drugs, anti-seizure medications, Botox, tranquilizers or dopamine in the case of Parkinson’s.  In some cases, tremor may also be treated with placement of a Deep Brain Stimulator (DBS).

  • Vocal Tremor is rhythmic contractions in muscles of voice production resulting in shaking of the vocal mechanism which we hear as shaking in the voice. 

Speech-Language Pathology Evaluation

Our Speech-Language Pathologists have specialty training in these conditions.

Assessment will include:

  • A detailed history collection
  • Laryngeal Function Studies consisting of computerized voice analysis and airway measures
  • Behavioral voice and communication analysis
  • Tailored assessment techniques to further assess for the presence of these conditions
  • Stimuability trials

Treatment

Spasmodic Dysphonia Treatment

  • The gold standard treatment for SD is Botox injections into the muscle that experiences the dystonia.   This can result in a weak or breathy voice, temporarily.  Injections typically need to be repeated every 3 to 6 months.  
  • Voice therapy is often a part of the overall treatment plan, to maximize healthy vocal function and allow patients to prolong time between injections.  

Vocal Tremor Treatment

  • Treatment generally consists of medication, if appropriate and / or Botox injections to the vocal mechanism.  
  • Voice therapy is often a part of the overall treatment plan, to maximize healthy vocal function and allow patients to prolong time between injections. 

Additional Information