Dystonia is a movement disorder characterized by persistent or intermittent muscle contractions causing abnormal, movements, postures, or both. Dystonia can be idiopathic, often running in families, and occurring without an associated medical or neurological disease diagnosis, or it can emerge following a brain injury such as a stroke. Dystonia can also co-occur with symptoms of other movement disorders such as Parkinson’s disease, MSA, or PSP. Initial symptoms can be very mild and noticeable only after prolonged exertion, stress, or fatigue. Dystonia affects men, women, and children of all ages and backgrounds, and currently, there is no cure.
Cervical dystonia (CD) is the most common of focal dystonias, and is characterized by abnormal posturing or involuntary movements of the neck, head, and shoulders. Like other types of dystonia, CD can have a major impact on quality of life, and studies have shown that a range of swallowing and voice difficulties may also accompany cervical dystonia. Oral-mandibular dystonia can cause painful spasms of the jaw muscles making eating or speaking difficult.
Spasmodic dysphonia (SD) affects the movement of the vocal folds and results in a voice impairment causing speech to sound strained or breathy. Spasmodic dysphonia often co-occurs with vocal tremor, and either may occur in isolation or be associated with other movement disorders. Botulinum toxin injections for Adductor SD remain the treatment of choice, and they can produce a significant reduction in voice breaks and speaking effort although the results vary even when the same physician employs the same dosage at regular intervals. Botox injections have been shown to be less beneficial or predictable for Abductor type dysphonia or vocal tremor.
Botox injections are typically administered at 3-4 month intervals. In addition to Botox injections for dystonia, patients often benefit from physical and speech therapy, and stress management strategies. Therapists, in fact, may be the first to identify a dystonia, and can be instrumental in referring patients for appropriate treatments.
Research is continuing to try to identify the brain basis for dystonias, and hopefully will lead to new treatment methods that will improve the quality of life for individuals in the future.
The National Spasmodic Dysphonia Association is dedicated to improving the lives of people affected by SD and related voice disorders. The NSDA mission includes: education, research, awareness, and support. Visit their website to subscribe to their newsletter and learn more: https://www.dysphonia.org/
Additional Resources: https://www.dystonia-foundation.org/what-is-dystonia
Fact Sheet: https://www.ninds.nih.gov/Disorders/Patient-Caregiver-Education/Fact-Sheets/Dystonias-Fact-Sheet
Spasmodic Dysphonia Research Opportunities
Researchers at Massachusetts Eye and Ear are conducting a study on SPASMODIC DYSPHONIA, VOICE TREMOR, and/or VOCAL FOLD NODULES. Please click on the links below for contact information.
SD-Tremor-Nodules drug trial-2
Visit the Voice Aerobics home page to learn more about programs and products to support voice use, to locate a class, or to schedule an evaluation: https://www.voiceaerobicsdvd.com/
My Mission: To enlist individuals in their treatment, and help them express their personality & spirit through voice. To educate and empower.
Mary Spremulli, MA, CCC-SLP