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What is Spasmodic Dysphonia?

Spasmodic dysphonia is a challenging and often misunderstood voice disorder that affects the vocal cords. Characterized by involuntary spasms that disrupt vocal cord movements, this

condition can significantly impact a person’s ability to speak and communicate effectively.

In this article, we’ll explore the various aspects of spasmodic dysphonia, including its types,

causes, symptoms, and the range of treatment options available.

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Understanding the Types of Spasmodic Dysphonia

Spasmodic dysphonia is a voice disorder characterized by involuntary spasms of the vocal

cords, which disrupt normal voice production.

Spasmodic dysphonia is primarily classified into three main types, each affecting voice

production in distinct ways and presenting unique challenges for diagnosis and management:

● Adductor Spasmodic Dysphonia

● Abductor Spasmodic Dysphonia

● Mixed Spasmodic Dysphonia

Adductor Spasmodic Dysphonia (ADSD)

The most common type of spasmodic dysphonia, Adductor Spasmodic Dysphonia, occurs when the vocal cords close too tightly and often. This excessive closure interrupts the normal vibration of the vocal cords necessary for voice production. As a result, individuals with ADSD typically experience choppy or jerky speech. Their voices can abruptly cut out or break, making their speech difficult to understand. This type of spasmodic dysphonia can be particularly straining as it often requires significant effort to speak.

Abductor Spasmodic Dysphonia (ABSD)

In contrast to ADSD, Abductor Spasmodic Dysphonia involves the vocal cords opening too

widely. In ABSD, the vocal cords fail to close properly, which leads to prolonged pauses in

speech and breathy or whispery sounds, as the voice tends to fade or even disappear

mid-conversation. This type can be especially challenging to manage because the voice's

unpredictability makes consistent communication difficult.

Mixed Spasmodic Dysphonia

The least common and most complex type is Mixed Spasmodic Dysphonia, which features

elements of both adductor and abductor types. Individuals with this form experience symptoms of both excessive closure and inadequate closure of the vocal cords, leading to a voice that can unpredictably break into a whisper or cut out entirely. Mixed Spasmodic Dysphonia is particularly difficult to diagnose and treat because the symptoms can vary widely, often mimicking other voice disorders, and may change over time.

Understanding these types is crucial for developing effective treatment strategies, as each type may respond differently to various therapies.

Spasmodic Dysphonia Treatment

Exploring the Causes of Spasmodic Dysphonia

The underlying causes of spasmodic dysphonia remain not fully understood, but research

suggests a combination of neurological, genetic, and environmental factors play a role in its


At its core, spasmodic dysphonia is believed to stem from dysfunction within the basal ganglia, a group of structures in the brain that are crucial for regulating voluntary motor movements and coordination. This dysfunction can lead to the misfiring of nerve signals that control the muscles of the vocal cords, resulting in the spasmodic symptoms characteristic of the disorder.

Genetics also appear to contribute to the risk of developing spasmodic dysphonia. Some

studies have found that the disorder can run in families, suggesting a possible hereditary

component. Environmental and emotional factors are also implicated in triggering or

exacerbating the symptoms of spasmodic dysphonia. Stress, for instance, is often reported by patients to worsen their symptoms.

While the exact mechanisms behind spasmodic dysphonia are complex and not entirely clear, it appears to result from an interplay of multiple unavoidable factors. Because of this, the most important measure you can take is staying educated and seeking early intervention at the first symptoms to mitigate its consequences.

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Recognizing the Spasmodic Dysphonia Symptoms

The symptoms of spasmodic dysphonia will vary from case to case, but there are still a few

symptoms you can keep an eye out for. If you recognize any of the following signs, it’s important to consult a speech-language pathologist as soon as possible:

● Voice Breaks: Sudden interruptions in speech, characteristic by the type of adductor.

● Strain and Struggle While Speaking: Individuals with spasmodic dysphonia often

experience difficulty speaking, which can be physically tiring and frustrating.

● Variability in Voice Quality: The voice may sound different from day to day or even

within the same day, often worsening with use and improving with rest.

● Breathy or Whispery Voice: Common in abductor type, where the voice can sound

weak and breathy.

While they can be difficult to recognize, it’s important to keep an eye out for each sign. Early

detection is crucial as it allows you to seek treatment before the condition worsens.

Spasmodic Dysphonia Treatment

Spasmodic dysphonia treatment

While there is no cure for spasmodic dysphonia, several effective treatments can help manage its symptoms and significantly improve communication. The choice of treatment often depends on the specific type of spasmodic dysphonia, its severity, and individual needs and preferences.

The most common treatment methods include:

● Botox injections

● Voice therapy

● Thyroplasty

● SLAD-R Surgery

Botulinum toxin injections

Botulinum toxin (Botox) injections are the primary treatment for spasmodic dysphonia. Botox is a neurotoxin that temporarily paralyzes muscles, reducing spasms when injected directly into the vocal cords. This treatment helps to stabilize the voice and make it less interrupted.

Botox is particularly effective for Adductor Spasmodic Dysphonia, where the vocal cords close too tightly, and also useful in cases of Abductor Spasmodic Dysphonia, to control the duration and frequency of vocal cord openings. The effects of Botox typically last for several months, necessitating periodic retreatment.

Voice Therapy

Voice therapy involves sessions with a speech-language pathologist who helps patients learn

exercises and techniques to improve vocal control and efficiency. This treatment can maximize voice function by teaching strategies to manage symptoms of spasmodic dysphonia, such as better breath support and voice projection. It may also involve relaxation techniques to reduce the overall effort of speaking.

Voice therapy is recommended for all types of spasmodic dysphonia and is especially beneficial for milder cases or for patients seeking non-invasive treatment options. It can also complement other treatments like Botox injections to enhance their effectiveness.


Thyroplasty is a surgical procedure that adjusts the position or tension of the vocal cords by

inserting an implant into the voice box. This operation helps stabilize the voice by physically

modifying the vocal cords to reduce spasms and improve sound production.

Thyroplasty is typically considered for patients with severe spasmodic dysphonia who have not responded well to Botox or for whom Botox's effectiveness has waned. As a more permanent solution compared to Botox, it offers lasting benefits but also carries the inherent risks of surgery.


Selective laryngeal adductor denervation-reinervation (SLAD-R) is a complex surgical option

aimed at permanently reducing spasms by reinnervating the muscles responsible for vocal cord closure. The procedure involves severing the nerves originally innervating the affected muscles and connecting them to different nerves that normally do not trigger spasms.

SLAD-R is usually reserved for severe cases of Adductor Spasmodic Dysphonia where less

invasive treatments have failed. Although it offers a more durable solution, the surgical outcome and recovery can vary, presenting a consideration of risks and benefits.

Spasmodic Dysphonia Treatment

Getting Started with Spasmodic Dysphonia Treatment

Treatment for spasmodic dysphonia typically involves a comprehensive evaluation to confirm

the diagnosis and determine the form and severity of the disorder. A treatment plan is then

tailored to the individual’s specific symptoms, lifestyle, and personal preferences.

To get started with your treatment, get in touch with an experienced speech-language

pathologist today. At Better Speech, a licensed specialist in spasmodic dysphonia is just one

click away. Our team specializes in diagnosing and treating a variety of speech and language disorders. Reach out to our skilled Speech-Language Pathologists for guidance on managing and improving communication skills. At Better Speech, we offer online speech therapy services convenient for you and tailored to your child's individual needs. Our services are affordable and effective - get Better Speech now.

Frequently Asked Questions

What is the prognosis for someone with spasmodic dysphonia?

The prognosis for someone with spasmodic dysphonia varies widely based on the type, severity, and response to treatment. While spasmodic dysphonia is generally considered a chronic condition, many individuals find their symptoms can be effectively managed with ongoing treatment. Regular Botox injections, voice therapy, or surgical interventions can help maintain a more stable voice. Early diagnosis and personalized treatment plans are key to improving outcomes.

Can spasmodic dysphonia go away on its own?

How is spasmodic dysphonia diagnosed?

Are there any lifestyle changes to help spasmodic dysphonia?

Can children develop spasmodic dysphonia?


About the Author

Aycen Zambuto

Aycen Zambuto

I’m a seasoned educator in speech therapy with over six years of experience helping people navigate challenges in communication. Throughout this time, I’ve found joy in guiding individuals through a variety of therapeutic journeys, from toddlers with apraxia to seniors with dysphonia.

I’m passionate about demystifying this complex world of speech therapy and helping readers around the globe achieve clear and effective communication. When I’m not writing about speech, you’ll often find me reading, traveling or spending time with friends and family.



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