Spasmodic Dysphonia

What is it?
Spasmodic dysphonia (or laryngeal dystonia) is a focal dystonia of the larynx that is a neurologic disorder.  Patients typically have overly active muscles that either close the vocal folds (adductor spasmodic dysphonia) or open the vocal folds (abductor spasmodic dysphonia).  There are patients with elements of both.  Depending on the form of spasmodic dysphonia, patients present with a characteristic strained voice (adductor) or breathy one (abductor).

How is it treated?
Neurological disorders of the larynx, including spasmodic dysphonia, can be further assessed using laryngeal electromyography (LEMG), which allows neurologic assessment of the patient’s larynx during continuous speech and identification of the abnormally functioning muscles.  Many patients get benefit from in-office, LEMG-guided botulinum toxin injection into specific muscles of the larynx.  Patients typically require repeat injections every 2-3 months for control symptoms.