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Spasmodic dysphonia

Spasmodic dysphonia (or laryngeal dystonia) is a voice disorder characterized by involuntary movements of one or more muscles of the larynx (vocal folds or voice box) during speech. Individuals who have spasmodic dysphonia may have occasional difficulty saying a word or two or they may experience sufficient difficulty to interfere with communication. Spasmodic dysphonia causes the voice to break or to have a tight, strained or strangled quality. more...

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Spasmodic dysphonia can affect anyone. The first signs of this disorder are found most often in individuals between 30 and 50 years of age. More women appear to be affected by spasmodic dysphonia than are men.

Types of spasmodic dysphonia

The three types of spasmodic dysphonia are adductor spasmodic dysphonia, abductor spasmodic dysphonia and mixed spasmodic dysphonia.

Adductor spasmodic dysphonia

In adductor spasmodic dysphonia, sudden involuntary muscle movements or spasms cause the vocal folds (or vocal cords) to slam together and stiffen. These spasms make it difficult for the vocal folds to vibrate and produce voice. Words are often cut off or difficult to start because of the muscle spasms. Therefore, speech may be choppy and sound similar to stuttering. The voice of an individual with adductor spasmodic dysphonia is commonly described as strained or strangled and full of effort. Surprisingly, the spasms are usually absent while whispering, laughing, singing, speaking at a high pitch or speaking while breathing in. Stress, however, often makes the muscle spasms more severe.

Abductor spasmodic dysphonia

In abductor spasmodic dysphonia, sudden involuntary muscle movements or spasms cause the vocal folds to open. The vocal folds can not vibrate when they are open. The open position of the vocal folds also allows air to escape from the lungs during speech. As a result, the voices of these individuals often sound weak, quiet and breathy or whispery. As with adductor spasmodic dysphonia, the spasms are often absent during activities such as laughing or singing.

Mixed spasmodic dysphonia

Mixed spasmodic dysphonia involves muscles that open the vocal folds as well as muscles that close the vocal folds and therefore has features of both adductor and abductor spasmodic dysphonia.

Origins

The cause of spasmodic dysphonia is unknown. Because the voice can sound normal or near normal at times, spasmodic dysphonia was once thought to be psychogenic, that is, originating in the affected personĀ¹s mind rather than from a physical cause. While psychogenic forms of spasmodic dysphonia exist, research has revealed increasing evidence that most cases of spasmodic dysphonia are in fact neurogenic or having to do with the nervous system (brain and nerves). Spasmodic dysphonia may co-occur with other movement disorders such as blepharospasm (excessive eye blinking and involuntary forced eye closure), tardive dyskinesia (involuntary and repetitious movement of muscles of the face, body, arms and legs), oromandibular dystonia (involuntary movements of the jaw muscles, lips and tongue), torticollis (involuntary movements of the neck muscles), or tremor (rhythmic, quivering muscle movements).

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evidence-based educator: General principles, The
From Dynamic Chiropractic, 8/16/02 by Masarsky, Charlews

With the research and clinical literature on the holistic benefits of chiropractic growing every year, there is no reason not to base your patient education efforts on solid science. When sharing the findings of our growing chiropractic literature with your patients, you may find these general principles useful:

1. Keep It Short: Describe the research and discuss its implications in just a few brief paragraphs. Ideally, the entire piece should fit on one side of a page.

2. Keep It Ethical: Do not claim that the research "proves" that chiropractic can "treat" heart disease, lung disease or any other condition. Simply state what the research suggests about the possible effects of the subluxation and the adjustment, without making unsupportable claims.

3. Keep It Plain: Minimize the use of technical terms, and explain any technical terms you do use in plain English.

4. Keep It Documented: Occasionally, a patient may ask to see the published research you are talking about. Always be able to produce the original paper or a credible summary (in a textbook, for example).

In each article from this group, I will provide you with a sample patient education article, written according to the above principles. Please feel free to reproduce it for your bulletin board, as a handout for lectures or tableside talks, or for your practice newsletter. Each article in this series will describe research documented in a new textbook, which I co-edited with Marion Todres-Masarsky,DC: Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach.

Without Botox

A chiropractic professor recently published the case of a man who had been unable-to speak for approximately six months. Every time the patient attempted to speak, the muscles controlling the vocal cords would go into spasm. In effect, the man was choking on his own words.

This puzzling speech disorder is called spasmodic dysphonia. One of the most common treatments for this disorder is to inject small amounts of the toxin that causes botulism (botulinum toxin, known by the trade name Botox) into the nerve that controls the vocal cords. By partially paralyzing the vocal cords, the spasm can sometimes be stopped, and speech may be restored.

The chiropractic professor detected a subluxation (pinched nerve) in the upper segments of the neck. Since the nerve that controls the vocal cords passes through this region, the chiropractic professor reasoned that the subluxation might be distorting the nerve signals, thereby creating the spasms. Five chiropractic adjustments were administered over a period of two weeks. The patient's normal voice was completely restored, without Botox.1

Thank you for your interest in this topic. I hope this information will contribute to your ability to make wise health care decisions and informed referrals.

Reference

1. This case study is discussed along with other research in the chapter titled, "The Somatovisceral Interface: Further Evidence" in Somatovisceral Aspects of Chiropractic: An Evidence-Based Approach (C.S. Masarsky and M. Todres-Masarsky, editors. Churchill Livingstone, publishers; 2001).

By Charles Masarsky,DC

Charles Masarsky,DC

Vienna, Virginia

neurofitness@aol.com

Copyright Dynamic Chiropractic Aug 16, 2002
Provided by ProQuest Information and Learning Company. All rights Reserved

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