Spasmodic dysphonia is a form of dystonia, a group of neurological disorders characterized by involuntary muscle spasms. It is a voice disorder involving involuntary spasms of the voice box muscles and causing the voice to break or to have a tight, strained, or strangled quality. Patients with spasmodic dysphonia may have difficulty communicating clearly.
There are two types of spasmodic dysphonia. In adductor spasmodic dysphonia, the vocal folds come together (adduct) tightly at the wrong time during speech, making it difficult to produce voice. In the more common abductor spasmodic dysphonia, the vocal folds move apart (abduct) at the wrong time during speech, causing air leaks. There may also be a combination of the two called mixed spasmodic dysphonia.
Although most commonly known for its cosmetic indications, botulinum toxin, also known as Botox, is a synthetic chemical that can be used to block nerve signal for treatment of a wide range of conditions, including voice disorders such as spasmodic dysphonia or vocal cord paralysis.
Injected directly into the vocal cords, Botox relaxes the muscles to relieve symptoms such as difficulty speaking and a tight, strained, or strangled quality to the voice. The medication weakens the vocal cord muscle to interrupt nerve signals for effective symptom relief.
Laryngeal Electromyography (EMG)
Laryngeal electromyography (EMG) is a diagnostic exam that evaluates the health of the vocal cord muscles and the nerves that control them by measuring muscle electrical activity. This test is most commonly performed to determine the cause of muscle weakness, as well as to predict recovery from vocal cord paralysis and other related conditions. It is often performed with Botox injections to ensure that the medication is injected into the proper muscle.
During the EMG exam, thin needle electrodes are inserted through the skin and into the muscle, where they detect electrical activity while the vocal cord muscle is at rest and contracting. Patients may experience mild pain when the electrodes are inserted, but this is tolerable for most. This test is usually performed in conjunction with a nerve conduction velocity test.
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