Spastic dysphonia, more properly known as spasmodic dysphonia, is a speech disorder where the muscles involved in controlling speech periodically spasm, making speech clipped, breathy, or tight. People with this condition may also have difficulty breathing and eating. It can become a disabling impairment, as the patient may not be able to work as a result of speech problems and can also experience social distress when trying 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 muscles used in speech. Some people have what is known as adductor spastic dysphonia, where the muscles pull together, pushing the vocal folds into each other and making it hard to speak. Others have an abductor form, where the vocal folds are pulled too far apart to allow for articulation of speech. A mixed type exhibiting characteristics of both can also be observed in some patients.
Diagnosing this speech disorder can be challenging. Some patients are initially assumed to be experiencing a psychological problem, such as difficulty speaking brought on by stress. In others, it may take time to confirm that there is definitely a neurological issue and to document the extent of the problem. Medical imaging of the brain is sometimes useful, as is inspection of the larynx. Doctors may also check for infection, nerve damage, and other potential causes of the condition to make sure they are making a correct diagnosis, as the approach to treatment of speech disorders is dependent on the underlying cause.
Several treatment options are available for spastic dysphonia. One is injections of botulinum toxin into the muscles to reduce spasticity. While people often associate this treatment with cosmetic procedures to manage facial wrinkling, it has a number of therapeutic applications, not just for spastic dysphonia but also for migraines and hand tremors. Patients may also pursue speech therapy to address the difficulty speaking and develop swallowing skills, if necessary.
The severity of this condition can vary. People with a history of spastic dysphonia may find it helpful to acquire alternative communication skills, such as using sign language or an augmentative communication board, to make sure they will be understood when they are having difficulty speaking. Workplace accommodations are available for people with this condition who need assistance with communication, including adaptive phone technology and placement in departments where spoken communication is not a critical need.
