Spasmodic dysphonia is a speech disorder caused by neurological problems that periodically contract muscles involved in speech, making it difficult to speak. Diagnosis can be difficult, but treatment options include botulinum toxin injections and speech therapy. Alternative communication skills and workplace accommodations can also be helpful.
Spastic dysphonia, more properly known as spasmodic dysphonia, is a speech disorder in which the muscles involved in controlling speech periodically contract, making speech slurred, wheezy, or strained. People with this condition may also have difficulty breathing and eating. It can become a disabling disability, as the patient may be unable to work due to speech problems and may also experience social discomfort when attempting to communicate orally.
This condition appears to be neurological in origin, caused by problems with the area of the central nervous system responsible for signaling the muscles used in speech. Some people have what is called spastic adductor dysphonia, in which the muscles stick together, pushing the vocal cords into each other and making it difficult to speak. Others have an abductor form, in which the vocal folds are too far apart to allow for speech to be articulated. A mixed type showing characteristics of both may also be seen in some patients.
Diagnosing this speech disorder can be difficult. It is initially assumed that some patients are experiencing a psychological problem, such as difficulty speaking caused by stress. In others, it may take some time to confirm that there is definitely a neurological problem and to document the extent of the problem. Medical imaging of the brain is sometimes helpful, as is inspection of the larynx. Doctors can also check for infections, nerve damage, and other potential causes of the condition to make sure they’re making a correct diagnosis, as the approach to treating speech disorders depends on the underlying cause.
There are several treatment options for spastic hoarseness. One is the injection of botulinum toxin into the muscles to reduce spasticity. Although people often combine this treatment with cosmetic procedures to manage facial wrinkles, it has a number of therapeutic applications, not only for spastic hoarseness, but also for migraines and hand tremors. Patients can also undergo speech therapy to address difficulty speaking and develop swallowing skills if needed.
The severity of this condition can vary. People with a history of spastic hoarseness may find it helpful to acquire alternative communication skills, such as the use of sign language or an augmentative communication board, to ensure they are understood when they have difficulty speaking. Workplace accommodations are available for individuals with the condition who need assistance with communication, including adaptive telephone technology and placement in departments where voice communication is not a critical need.
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