By Lyn Dee Harrelson
Neurological Concomitants in
Spasmodic Dysphonia
By Lyn Dee Harrelson
treatment
There are no specific guidelines
to identify what people perceive as a normal voice. In some
cases, a therapist may consider a person's voice to be abnormal,
while the client feel the voice is normal. While the reverse may
happen when the client feel the voice quality is not adequate,
but he therapist feel that it is. Robyn Mundy, in his article
Mislaid Voices featured in the March 1999 NSDA Newsletter, made a
good point when he reported that although SD does not impact the
function of the brain in relation to intellect, personality,
memory, emotion, sight or hearing, but it [SD] can have a
profound influence on social and professional interaction as well
as emotional well-being. In identifying true SD as an organic
disorder associated with malfunction of
the basal ganglia, it is important to remember that SD is not a
curable disorder with the current treatment options available
today. There are three different treatment options used today
surgical, medical, and behavioral.
Surgical
Nerve resection
Resection of the recurrent laryngeal nerve was the most common
treatment for SD up until the 1980's. This procedure consists of
the recurrent laryngeal nerve. This is a permanent condition that
eliminates all impulses to the intrinsic muscles of the larynx.
Other resources for information:
Medical
Botox Injection
Botulinum toxin is inserted into the hyperfunctioning laryngeal
muscle. This provides temporary relief of laryngeal spasms. The
Botulinum acts as a barrier at the level of the motor end plate
and blocks the passage of the signals from the brain that trigger
the movement of the hyperactive laryngeal muscle. The effects of
this toxin usually last anywhere from four to six months.
Some adverse effects are:
· Difficulty swallowing
· Periods of breathiness in voice
· Inevitable deterioration of normal voice characteristics
Other less effective medications prescribed are:
Tranquilizers
Muscle relaxants
Antihistamines
Antacids
Antidepressants
Other sources of information:
CSOM: Treating Spasmodic Dysphonia with Acupuncture
Behavioral
Voice Therapy
Although with true SD, voice therapy cannot cure the spastic
characteristics of the laryngeal muscles, it can provide relief
from the symptoms. Voice therapy offers the client options for
dealing with laryngeal spasms. Relaxation techniques help to make
the person more aware of how they are reacting to the way they
speak and help them to reduce excess tension. Therapy also
provides education about the laryngeal anatomy and as well as
identifying some environmental factors that might trigger
increase spastic activity. By incorporating a behavioral therapy
component into whatever treatment technique chosen, the client is
more likely to achieve more success with speaking. Behavioral
intervention is less invasive than alternative treatments for SD.
By allowing behavioral intervention the opportunity to work does
not hinder any other optional treatment such as laryngeal nerve
resection or Botox injection. Behavioral intervention is
necessary for treatment of patients with SD.
Emotional Component
This is an important component to remember when dealing with a
person with SD. These people are trying to deal with a permanent
voice characteristic that is not their own. In all daily
activities they are reminded that their voice is different and
draws attention. It distorts how people look at them and has an
impact on their life and how they live it. Along with treating
the symptoms of SD, remember to address these people's feelings
and educate them as best as possible on how to deal with this
disorder in their everyday life.
Additional Resources for information:
Spasmodic Dysphonia Bulletin Board
