Spasmodic Dysphonia: Causes, Symptoms, and Treatment

Medically Reviewed by Neha Pathak, MD on July 24, 2023
4 min read

Spasmodic dysphonia (or laryngeal dystonia) is a rare voice disorder that is thought to happen when your brain sends abnormal signals to your vocal folds. It only affects about 1 in 100,000 people. With this condition, the muscles in your larynx (or voice box) have spasms – or tighten up – when you use your voice. While it can happen in children or much older people, it usually shows up in middle-aged people. Both men and women can have SD, but women are affected more.

With this disorder, your voice may sound:

  • Hoarse
  • Whispered or breathy
  • Shaky
  • Trembly
  • Tight
  • Strained
  • Jerky

People with spasmodic dysphonia sometimes describe their voices as sounding “off” or “not right.”

Your symptoms will usually happen gradually over your first and second year of having the disorder. Then, they’ll stop progressing and stay the way they are.

While your voice may sound different when you speak, your larynx often acts normally when you do other things. You may not notice symptoms when you:

  • Cry
  • Laugh
  • Breathe
  • Hum
  • Sing
  • Swallow

Experts don’t fully understand what causes spasmodic dysphonia. They’re looking into how it’s related to an issue in your brain, specifically in the area called the basal ganglia. They’re also studying possible genetic links.

The muscle spasms in your larynx are sudden and cause your vocal cords to move in strange ways. This causes your voice to sound different. The spasms will start and stop as you use your voice. There might be a link between more spasms and higher stress.

Spasmodic dysphonia can be tough to diagnose because your larynx looks normal on MRI and CT scans. The symptoms can also be very similar to other conditions.

To get a proper diagnosis, you’ll likely need a few experts on your health care team. These include a:

  • Neurologist. This doctor focuses on the brain and nervous system.
  • Speech-language pathologist. This expert specializes in voice, language, and speech disorders.
  • Otolaryngologist (ENT). This specialist looks at your ears, nose, throat, head, and neck. A type of otolaryngologist, called a laryngologist, usually needs to also confirm your SD diagnosis.

Your care team will listen to your voice to get a better idea of your symptoms. 

An otolaryngologist may also do a test on you called a videostroboscopy. This looks at your larynx and listens to your voice. The doctor will put a small tube through your nose into the back of your throat. The tube is lit and will show them your larynx and vocal cords and how they move when you use your voice.

They may use imaging tests like an MRI to check for issues in your brain. But this isn’t usually done.

While there’s no cure for this disorder, there are treatments you can use to lessen the symptoms:

Botox (botulinum toxin) shots. A specialist can inject a small amount of this toxin into your vocal folds to relax the muscles. Every treatment usually lasts a few months.

Myofascial release. This treatment puts pressure on the outside of your throat and stretches your muscles to ease symptoms.

Anti-anxiety medications. Oral (taken by mouth) medications for anxiety can help ease stress, which can make your symptoms worse.

Selective laryngeal adductor denervation-reinnervation (SLAD-R). This is a surgery that cuts specific nerves that you use while you speak. Then, it reconnects them in a different way. This process might break the nerve path from your brain to your vocal cords.

Thyroplasty. There are two types of this procedure for spasmodic dysphonia. One splits your vocal folds to stop your larynx from closing too tightly. The other places your vocal folds closer together to stop them from opening too much.

Voice therapy. Your speech-language pathologist can teach you ways to change how you talk. This may help lessen the effects of SD.

There is no way to prevent spasmodic dysphonia. In some conditions, you can avoid or begin certain habits that might affect the condition. But with this disorder, there are no risk factors or lifestyle behaviors that will lower your chances of getting it.

Spasmodic dysphonia is a condition that’ll last your whole life. While you can treat it to calm its symptoms, they’ll eventually come back.

To learn how to live a high-quality life with this disorder, you can try a few things:

Voice devices. These tools can help you use your voice more effectively with spasmodic dysphonia. They may make your voice louder in person or over the phone or use computer software and smartphone apps to translate text into speech.

Support groups. You can find local groups for people with spasmodic dysphonia. These can help you connect with others and learn new tips and tricks from people who have similar issues with their voices.

Self-care. If you’re sleepy or stressed with this condition, it can make your symptoms worse. Make sure that you take care of yourself, ease anxiety, and get good rest.

Help from loved ones. Don’t let spasmodic dysphonia stop you from spending time with friends and family. Ask them for support and understanding. They can also be a great outlet to express your feelings about the disorder.

Counseling. A trained expert can be a great resource to help you cope with the symptoms of this disorder. They can help you learn how to function better in social and career settings.

Experts are still learning more about the disorder so that they can find other causes, ways to diagnose it, and new treatments.