SPASMODIC DYSPHONIA
Spasmodic dysphonia is a neurological disorder that affects the muscle of the voice box or larynx and ultimately affects speech.
- The vocal cords or vocal folds are located inside voice box, or larynx. During speech, air from the lungs is pushed between the vocal cords.
- Sufficient air pressure causes the vocal cords to vibrate in just the right way to produce voice
- With spasmodic dysphonia, an abnormal nerve signal is received by the muscle in the vocal cords causing the vocal cords to experience sudden uncontrollable movement, this disrupts the ability of the cords to vibrate and produce voice. This sudden uncontrollable movement is referred to as spasm.
- These spasms cause the voice to break with a strained, tight or strangled voice,
- Spasmodic dysphonia is a lifelong condition and can cause problems ranging from trouble saying a word or two to being able to talk.
- It is prevalent in women, particularly between the ages of 30 and 50.
- Three main types of spasmodic dysphonia exist. They include:
- Adductor spasmodic dysphonia: This is the most common type of spasmodic dysphonia. It is characterized by an uncontrolled muscle spasm cause vocal cord to close and stiffen. These spasms make it difficult for the cords vibrate and make sounds. Words may be difficult to start or are often cut off due to the muscle spasm
- Abductor spasmodic dysphonia: it is characterized by a sudden involuntary spasm that makes the vocal cords open too far, preventing the cords from vibrating. This allows extra air to leave the lungs during speech. This type of dysphonia may cause the voice to sound weak, quiet and whispery.
- Mixed spasmodic dysphonia: this is the rarest form of the condition and is the combination of the other types of spasmodic dysphonia. In this type, the muscles that open and close the vocal cord are abnormally functioning. It is characterized by symptoms related to both adductor and abductor spasmodic dysphonia.
CAUSES
The cause of spasmodic dysphonia is unknown. However, it is thought to be caused by abnormalities in an area of the brain called the basal ganglia.
Factor that may predispose an individual to spasmodic dysphonia may include:
- Dystonia, a brain disorder that tightens the muscle
- Stressful events
- Upper respiratory tract infections
- Heavy voice use
- A family history of neurological diseases
- Pregnancy
- Childhood measles
- Sinus and throat illnesses
SYMPTOMS
Symptoms of adductor spasmodic dysphonia may include:
- Increased effort in speaking
- Strained, strangled voice
- Voice cuts out while speaking
Symptoms of abductor spasmodic dysphonia may include:
- Breathy voice
- Weak, quiet or whispery voice
- Soundless breaks in voice
- Increased effort while speaking
- Voice cuts out while speaking
DIAGNOSIS AND TREATMENT
DIAGNOSIS
The condition may be difficult to diagnose because symptoms are often similar to other voice disorders.
A team of professional carry out diagnosis by conducting a careful examination
- A speech-language pathologist assesses the quality and production of voice by listening to how your voice sounds. This assessment may include questions to gather information about voice use and symptoms.
- An otolaryngologist, or ENT doctor examines the vocal cords structure and the activity of the muscles controlling them during speech. This is done to check for other possible causes of the voice disorder. A procedure called transnasal flexible fiberoptic laryngoscopy may be used to achieve this.
- A neurologist evaluates the patient to look for signs of brain (neurological) problems that may lead to such disorder.
TREATMENT
No cure exists for spasmodic dysphonia. However, some treatments are available that can help to reduce symptoms. This treatment may include:
Botulinum toxin or Botox may be injected into the vocal cords. The toxin prevents spasm by blocking nerve signals to the brain.
Voice therapy may help produce a better voice.
A psychological counseling may be able to help patient accept and live with their voice condition