Laryngeal Dystonia (also known as spasmodic dysphonia or spastic dysphonia)
The following information is taken from our factsheet, Laryngeal dystonia.
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Laryngeal dystonia
In laryngeal dystonia the vocal cords are affected by involuntary spasms. These involuntary spasms of the vocal cords cause the voice to change in quality.
When the vocal cords are pulled together (adductor laryngeal dystonia), the voice tends to have a 'strangled' quality. If the vocal cords are pulled apart (abductor laryngeal dystonia) the voice can be 'breathy' and very quiet. Like most types of dystonia, laryngeal dystonia can be made worse when people are anxious or tired.
In most people the condition has no known cause and usually starts in mid-life, but does not affect the mind or the senses. Sometimes the vocal cords are the only part of the body affected, but in some cases other muscles nearby can be affected, such as the neck, mouth and the muscles around the eyes.
How can laryngeal dystonia be treated?
To date, no cure exists for laryngeal dystonia, although a great deal of research is being undertaken around the world, with significant progress. Whilst treatment for this condition is not essential since it is neither life-threatening nor life-shortening, those who depend on their voices for their work will usually need to be treated if they are to continue in work.
Treatment of laryngeal dystonia can be difficult, and results of treatment vary greatly between different people. The principal treatment involves the injection of botulinum toxin to weaken the muscles affected by spasm. Injections have to be repeated every three months or so. Injections into the vocal cords are technically quite difficult, and a very precise dose needs to be given to avoid weakening the muscle too much. Any excessive weakness of the injected muscles is usually temporary.
Because of these difficulties, muscles are usually injected using electromyography (EMG) - a tool that helps identify which muscles are affected most by the dystonia, and is only usually performed by ear, nose and throat (ENT) doctors with special training.
Some people with laryngeal dystonia can gain benefit from speech therapy. In other people, tablet treatment can be tried, although the results can be quite variable from person to person and side effects can occur.
More information on botulinum toxin
How do I live with laryngeal dystonia?
Laryngeal dystonia can be a challenging condition to live with. The poor quality of your voice can make it difficult for you to make yourself understood and it can make you feel embarrassed and self-conscious in company.
Giving a brief explanation to new folk you meet can ease their concerns that you might strain your voice by speaking, for example: 'I have a neurological condition which affects my speech but it's not painful and I won't do any damage by talking to you.'
As with all forms of dystonia, a positive attitude is important. Learning about laryngeal dystonia and communicating with others with the condition may help you come to terms with it and to find the best ways of coping with your specific symptoms.