National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Spasmodic dysphonia


Other Names:
Abductor spasmodic dysphonia (type); Mixed spasmodic dysphonia (type); Adductor spasmodic dysphonia (type); Abductor spasmodic dysphonia (type); Mixed spasmodic dysphonia (type); Adductor spasmodic dysphonia (type); Laryngeal dyskinesia; Laryngeal dystonia; Spastic dysphonia See More
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Spasmodic dysphonia is a disease caused by involuntary movements of one or more muscles of the voice box (larynx). Signs and symptoms may range from occasional difficulty saying a word or two to substantial difficulty speaking that interferes with communication. Spasmodic dysphonia causes the voice to have a tight, strained, or strangled quality. While the cause of spasmodic dysphonia is unknown, some researchers think it might be caused by problems with the basal ganglia in the brain.[1]

Some cases of spasmodic dysphonia occur along with other diseases that affect the nervous system such as movement disorders. Spasmodic dysphonia may be inherited, or it may occur after a trauma to the voice box such as an injury or a severe cold. Diagnosis of spasmodic dysphonia is based on an exam by a multidisciplinary team, including an otolaryngologist. This exam may include a videolaryngostroboscopy. Treatment may include surgery, Botox injections, and speech therapy.[1] 
Last updated: 9/20/2017
There is a wide range of speaking difficulty that may be associated with spasmodic dysphonia. Some affected individuals may occasionally struggle to say a word or two, while others may have substantial difficulty speaking that interferes with communication. Some types of speech, such as singing, laughing, or yelling, may be unaffected.[2] There are three different types of spasmodic dysphonia:[1]
  • Adductor spasmodic dysphonia: causes the vocal cords to close and stiffen, resulting in a strained voice
  • Abductor spasmodic dysphonia: causes the vocal cords to stay open, resulting in a weak and quiet voice
  • Mixed spasmodic dysphonia: causes the vocal cords to both open and close inappropriately, resulting in a mix of symptoms

While anyone can be affected, spasmodic dysphonia more often affects women and is more likely to begin between the ages of 30 and 50 years.[1] The onset of symptoms may be sudden or may be relatively mild and progress over a period of time.[2] Some individuals with the disease may have a tremor (shaking) in other body parts, such as the hands, or symptoms of another neurological disease.[3]
Last updated: 9/20/2017
The cause of spasmodic dysphonia is unknown.[1][3][4] Some researchers think that spasmodic dysphonia is caused by problems with a structure in the brain called the basal ganglia. The basal ganglia control involuntary movements in the body, including the involuntary movements of the vocal cords. Specifically, it is thought that the chemical signals (neurotransmitters) in the basal ganglia do not work correctly in people who have spasmodic dysphonia. When the neurotransmitters do not work correctly, the basal ganglia cannot communicate with the voice box to tell the vocal cords when to move.[3][4]

For some people, the onset of symptoms may occur after an illness, after an injury affecting the voice box, or after a time of emotional stress. Other individuals with spasmodic dysphonia cannot identify a reason that they developed symptoms of the disease.[1][3]

Last updated: 9/20/2017
In some cases, individuals with spasmodic dysphonia may have family members with spasmodic dysphonia or other neurological disorders.[5] In these cases, it is thought that the disease is inherited, or that families may share a combination of genetic factors and environmental factors that cause the disease to run in the family.[2] In other cases, a person who is diagnosed with spasmodic dysphonia may be the only affected individual in the family. People who have family members with spasmodic dysphonia may be at an increased risk to develop the disease.[4] Current research regarding spasmodic dysphonia is focusing on possible genetic causes of the disease.[3]
Last updated: 9/20/2017
Diagnosis of spasmodic dysphonia is based on clinical evaluation by a multidisciplinary team of healthcare providers. This team may include a speech-language pathologist who evaluates voice production and voice quality, a neurologist who rules out other neurological diseases that may cause spasmodic dysphonia, and an otolaryngologist who examines the vocal cords and their movements. A procedure called videolaryngostroboscopy is often performed to assess the vibration of the vocal cords. This procedure uses a very small camera to record if the vocal cords are vibrating correctly during speech.[3] Other procedures may include imaging of the brain using a CT scan or MRI to rule out other neurological disorders.[3]
Last updated: 9/20/2017
The treatment for spasmodic dysphonia focuses on improving symptoms of the disease. Treatment options include speech therapy, Botox injections into the vocal cords, and surgery to try to fix the opening or closing of the vocal cords.[1][3] The exact treatment that will be available depends on the type of spasmodic dysphonia each affected individual has.[3]
Last updated: 9/20/2017
Spasmodic dysphonia is not expected to shorten a person’s life span. For some people, the symptoms of spasmodic dysphonia may affect communication with others, which can affect the quality of life in both work and social situations. The stress associated with struggling to communicate can also cause depression and anxiety.[2] Technology that aids with communication may be a useful tool to improve the quality of life of individuals affected with the disease.[1] 
Last updated: 9/20/2017

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • ClinicalTrials.gov lists trials that are related to Spasmodic dysphonia. Click on the link to go to ClinicalTrials.gov to read descriptions of these studies.

    Please note: Studies listed on the ClinicalTrials.gov website are listed for informational purposes only; being listed does not reflect an endorsement by GARD or the NIH. We strongly recommend that you talk with a trusted healthcare provider before choosing to participate in any clinical study.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease

These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

  • The National Institute on Deafness and Other Communication Disorders (NIDCD) conducts and supports biomedical and behavioral research and research training in the normal and disordered processes of hearing, balance, smell, taste, voice, speech, and language. Click on the link to view information on this topic. 
  • The National Organization for Rare Disorders (NORD) has a report for patients and families about this condition. NORD is a patient advocacy organization for individuals with rare diseases and the organizations that serve them.

In-Depth Information

  • Medscape Reference provides information on this topic. You may need to register to view the medical textbook, but registration is free.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know.

  1. Spasmodic Dysphonia. National Institute on Deafness and Other Communication Disorders (NIDCD). March 6, 2017; https://www.nidcd.nih.gov/health/spasmodic-dysphonia.
  2. Jinnah HA. Laryngeal Dystonia. National Organization for Rare Disorders. 2017; https://rarediseases.org/rare-diseases/laryngeal-dystonia/.
  3. Pitman MJ, Kamat AR, and Baredes S. Spasmodic Dysphonia. Medscape Reference. June 15, 2017; http://emedicine.medscape.com/article/864079-overview.
  4. Spasmodic Dysphonia: Causes. National Spasmodic Dysphonia Association. https://www.dysphonia.org/causes.php. Accessed 9/20/2017.
  5. Hintze JM, Ludlow CL, Bansberg SF, Adler CH, and Lott DG. Spasmodic Dysphonia: A Review. Part 1: Pathogenic Factors. Otolaryngology Head and Neck Surgery. August 1, 2017; https://www.ncbi.nlm.nih.gov/pubmed/28850801.