Dos
- Do expect to repeat botulinum toxin injections roughly every three to four months
- Do mention if laughing or singing sounds noticeably clearer than speaking — this supports the diagnosis
Spasmodic Dysphonia
Consultant-led diagnosis and treatment for spasmodic dysphonia, a neurological voice disorder causing involuntary spasms of the voice box muscles.
What is the condition?
Spasmodic dysphonia is a focal dystonia affecting the muscles that control the vocal cords, causing involuntary spasms during speech. In adductor spasmodic dysphonia (the more common form) the cords spasm shut, giving a strained, strangled voice quality; in abductor spasmodic dysphonia the cords spasm open, causing sudden breathy breaks in speech.
Symptoms
What to look out for?
Symptoms are specific to voluntary speech and typically don't occur with laughing, crying or singing, which helps distinguish it from other voice disorders.
- A strained, strangled or "squeezed" voice quality (adductor type)
- Sudden breathy breaks or whispered dropouts in speech (abductor type)
- Symptoms that fluctuate and worsen with stress or fatigue
Treatment
What can be done?
Botulinum toxin (Botox) injections into the affected laryngeal muscles are the gold-standard treatment, weakening the spasming muscle to allow smoother speech. Injections are typically repeated every three to four months as the effect wears off.
- Botulinum toxin injections into the laryngeal muscles
- Voice therapy alongside injections
Prevention
What should I do?
Don'ts
- Don't expect a single injection to be a permanent cure — it is a repeated, managed treatment