Spasmodic Dysphonia

Spasmodic dysphonia is a rare speech disorder that affects how your voice sounds. It can make your voice suddenly sound breathy, strained or as if you’ve lost your voice. Spasmodic dysphonia symptoms may come and go. There’s no cure for it, but there are treatments, including medication and voice therapy.


What is spasmodic dysphonia?

Spasmodic dysphonia is a rare speech disorder that affects your vocal cords, making your voice change and sound different. Your voice may break, sound tight and strained or very breathy. Spasmodic dysphonia may make it hard for people to understand what you’re saying. It may make you feel anxious or uncomfortable when you’re talking to other people. Healthcare providers can’t cure spasmodic dysphonia, but they do have treatments that ease your symptoms.

How common is spasmodic dysphonia?

Spasmodic dysphonia affects around 500,000 people in the U.S. Women and people assigned female at birth (AFAB) are more likely to have this condition than men and people assigned male at birth (AMAB). It can start at any age, but spasmodic dysphonia usually begins between ages 30 and 60.

Types of spasmodic dysphonia

  • Adductor spasmodic dysphonia: This is the most common type, making your voice suddenly sound strained, tight and hoarse.
  • Abductor spasmodic dysphonia: The second most common type makes your voice sound very breathy. You may lose your voice, so there’s no sound when you talk.
  • Mixed spasmodic dysphonia: Rarely, some people have issues where their voices turn strained, tight and breathy.

Any of these types may cause vocal tremor, which makes your voice sound shaky.


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Symptoms and Causes

What are the symptoms of spasmodic dysphonia?

Spasmodic dysphonia changes how your voice works and sounds. Its symptoms develop gradually. People with spasmodic dysphonia describe their voices as sounding:

  • Breathy, soft or like they’re whispering.
  • Strained and tight.
  • Hoarse.
  • Broken because certain sounds cut off while they’re speaking.
  • Shaky or trembling.

What causes spasmodic dysphonia?

Spasmodic dysphonia is a neurological problem that researchers think starts with your basal ganglia, an area of the brain that helps coordinate our body’s movements.

The problem makes the muscles in your larynx (voice box), including your vocal cords, go into spasms. The spasms may make your vocal cords get very tight, making your voice sound strained. When your vocal cords come apart, your voice sounds breathy. Experts don’t know what triggers these spasms.


Diagnosis and Tests

How is it diagnosed?

Otolaryngologists and speech-language pathologists (SLPs) will listen to you as you speak and will do a videostroboscopy to look at your larynx and vocal cords.

Management and Treatment

What’s the treatment for spasmodic dysphonia?

Healthcare providers can’t cure spasmodic dysphonia, but there are treatments to ease vocal cord spasms that affect your voice. Treatments may include:

  • Botox® injections.
  • Voice therapy.
  • Thyroplasty.
  • Selective laryngeal adductor denervation-reinnervation (SLAD-R), surgery that improves muscle control by disconnecting and reconnecting nerves between your brain and your vocal cords.

You can also use technology that makes your voice sound louder or translates typed text into speech.


Outlook / Prognosis

What can I expect if I have spasmodic dysphonia?

Spasmodic dysphonia is a chronic, lifelong condition. Your symptoms may come back even after you have successful treatment.

Living With

Spasmodic dysphonia is a chronic condition that affects the way you sound. Severe spasmodic dysphonia may affect your ability to communicate. Here are some suggestions that may help you to live with it:

  • Practice self-care: Being tired or stressed out can worsen the symptoms of spasmodic dysphonia. Take good care of yourself and get enough rest to help manage symptoms.
  • Consider counseling: A counselor may help you cope with the symptoms and their effects on your ability to work and socialize. Some counselors specialize in how to adjust your work life.
  • Stay connected: You may feel self-conscious about your voice. If your voice changes mid-conversation, consider explaining why it happens.
  • Support groups. Support groups can connect you with other people who understand the challenges of spasmodic dysphonia.

When should I see my healthcare provider?

Contact your healthcare provider when you notice your voice changing more frequently than usual.

What questions should I ask my healthcare provider?

You may want to ask the following questions:

  • What caused my condition?
  • What treatments do you recommend?
  • Will the treatments fix my condition?
  • What can I do to help myself?

A note from Cleveland Clinic

Spasmodic dysphonia affects how your voice sounds. It may make your voice sound breathy, strained or raspy. The changes may come and go, so you can’t predict when your voice will suddenly sound very different. If you have this condition, you may feel uncomfortable or anxious about using your voice to communicate. Unfortunately, spasmodic dysphonia is a chronic condition that healthcare providers can’t cure. They can, however, help you with medication, therapy and other steps that may make your voice changes less noticeable.

Medically Reviewed

Last reviewed on 09/05/2023.

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