SPASMODIC DYSPHONIA...A Blog Summary

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Spasmodic Dysphonia (SD) is a relatively rare, chronic speech disorder.  It only affects about 4 in 100,000 people and often goes undiagnosed for some time since the symptoms are similar to other speech disorders.  SD is more often diagnosed in women in the 30-50 age group, but it can affect both sexes and any age group.  While there are three types of SD, all typically cause the voice to “tighten and break” and gives voice a strained sound due to involuntary muscle contractions.  This disorder often starts with mild symptoms which get much worse over time. Many patients with SD find temporary relief lasting up to about four months by obtaining botox injections.  The injections are given directly into the affected muscles of the larynx.  The person with SD often has great difficulty speaking and those around them have problems understanding what is being said. It may take awhile before a diagnosis for this rare disorder is received which creates extra anxiety and emotional distress to those affected.  This is an isolating condition and those suffering with SD are encouraged to seek out support groups.

Three important facts about Spasmodic Dysphonia:

• SD is a rare, chronic speech disorder may affect anyone and it often gets worse over time.
• SD makes the voice  “tighten and break” and gives voice a strained sound due to involuntary muscle contractions.  It is difficult to speak and others have difficulty understanding what is being said.  This creates additional emotional distress for those with this condition.
• Botox injects give many temporary relief from the symptoms.  Injections must be obtained about every four months.

"SPASMODIC DYSPHONIA: When No Words Come Out"

Following is a personal story on Spasmodic Dysphonia reported by ABC News' correspondant, David Muir.  It was featured on ABC News in Ausust  2008.

"Scott Adams is the cartoonist who gives Dilbert a voice -- a gift he wishes he could give himself. "It feels like you're being strangled from the inside out," he told ABC News' David Muir. That's right -- strangled. Adams said he literally chokes on his own words. It's a strange and isolating condition that began after what seemed like normal laryngitis.   "I couldn't talk normally for over a year," Adams said. "I still don't talk normally." 
Read more about Scott's story at:
http://abcnews.go.com/Health/MedicalMysteries/story?id=5480171

SPEAK TO ME...

At this year’s ASHA's Annual Convention,  "attendees were welcomed by a music video showcasing a song produced to celebrate and recognize audiologists and speech-language pathologists. The song, "Speak to Me," was written by one of ASHA’s staff members, IS Director Mike Guerrieri.

Mike was inspired to write this song primarily because of his mother and her struggles with a communications disorder."

Check Out These Two Professional Articles about SD!

1. "Outcomes of Botulinum Toxin Treatment for Patients with Spasmodic Dysphonia."

Botulinum Toxin injections remain one of the leading treatments in the fight against Spasmodic Dysphonia (SD). But, what is the actual effect SD has on the quality of life? Michael S. Benninger, MD; Gelendon Gardner, MD; and Cynthia Grywalski, CCP-SLP took a closer look at this question by using a system called Voice Handicap Index (VHI) to measure the difference in the quality of life of 30 SD patients before and after Botulinum Toxin injections. The VHI uses a five point scale survey that measures the physical, functional, and emotional impact of SD. The study concluded that 22 of the 30 patients who completed the survey, post treatment, showed substantial improvement in their quality of life.

            Benninger, MD, Michael S., Glendon Gardner, MD, and Cynthia Grywalski, CCP-SLP.   "Outcomes of Botulinum Toxin Treatment for Patients with Spasmodic Dysphonia."   Arch Otolaryngology Head Neck Surgery 127.9 (2001): 1146-148. Print.

2. "Research Priorities in Spasmodic Dysphonia."

            In 2008, a diverse group of scientists and clinicians were assembled to analyze current Spasmodic Dyspohonia (SD) information and to decide on the top research priorities regarding the condition. (Backgrounds of the medical group gathered included: neurology, speech pathology, genetics, neuroscience, and otolaryngology.) The group hoped to gain a better understanding of the causes of SD, its diagnosis, as well as ways to improve available treatments. Ultimately, the group aimed to greatly improve the care of SD patients through speech pathology, neurology, and otolaryngology. The identification of risk factors of the disorder was deemed the top priority of research involving SD.  

Tanner, MD, PhD, Caroline M., H. A. Jinnah, MD, PhD, Andrew Biltzer, MD, DDS, Sandra B. Martin, MS, et al. "Research Priorities in Spasmodic Dysphonia." Otolaryngology-  Head and Neck Surgery 139.4 (2008): 495-505. Print.

Learn More About SD At These Three Great Sites!

-National Institute on Deafness and Other Communication Disorders

The National Institute on Deafness and Other Communication Disorders (NIDOCD) website offers a clear explanation of Spasmodic Dysphasia. The site describes the three types of DS, who is affected by DS, and the causes of the condition. The National Institute on Dearness and Other Communication Disorders defines Spasmodic Dysphasia as, “a voice disorder caused by involuntary movements of one or more muscles of the larynx or voice box.”  The site provides NIDOCD’s a definition of three types of SD:

• Adductor spasmodic dysphonia, a sudden closing of the vocal folds,
• Abductor spasmodic dysphonia, a sudden opening of the vocal folds, and
• Mixed spasmodic dysphonia, a sudden opening and closing of the vocal folds.

The website also identifies who is typically affected by the disorder: anyone can have SD, but the initial signs of the disorder are commonly found in individuals between the ages 30-50.

The site also suggests probable causes of SD. While the specific cause of the condition remains unknown, research suggests Spasmodic Dysphasia may be related to other disorders, it may be inherited, or it may even be neurogenic.

http://www.nidcd.nih.gov/health/voice/spasdysp.html

-American Speech-Language-Hearing Association

The American Speech-Language-Hearing Association website offers a clear, easy to comprehend overview of two important Spasmodic Dysphasia questions: how spasmodic dysphasia is diagnosed, and what treatments are available. Spasmodic Dysphasia diagnosis typically involves visits to a speech pathologist for a voice evaluation, an otolaryngologist for a vocal cord examination, and a neurologist visit. In terms of treatments for SD, there is no cure. However, Botox injections into the vocal cords may offer some relief.

Psychological counseling is recommended to help with the coping process which typically follows diagnosis. More information about SD diagnosis and treatment is available at the American Speech-Language-Hearing Association website. http://www.asha.org/public/speech/disorders/spasmodicdysphonia.htm

-National Spasmodic Dysphonia Association

In addition to general information, The National Spasmodic Dysphonia Association website offers video and audio clips related to Spasmodic Dysphasia. These resources allow viewers to hear and see different aspects of the disorder. The videos range from “What is Spasmodic Dysphonia?” to “Botulinum Toxin.” Viewers witness a patient receiving a Botox treatment injection into the muscles of his vocal cords. Audio clips on the website allow viewers to hear distinct differences in abductor spasmodic dypshonia and adductor spasmodic dysphonia. Perhaps the most helpful audio clip demonstrates the effect of a Botox treatment on a patient pre- and post- treatment. The National Spasmodic Dyphonia Association website is a wonderful tool for viewers to see and hear different aspects of Spasmodic Dysphasia.

http://www.dysphonia.org/

Can You Hear Me Now?

Diane Rehm from NPR's
"The Diane Rehm Show"

Spasmodic Dysphonia (SD) is a chronic voice disorder.  People who have this disorder sometimes may sound "normal" and then other times have great difficulty speaking.  A person's voice may sound "tight", delayed and break up.  I first became aware of SD when Diane Rehm from NPR's, The Diane Rehm Show, was diagnosed.  Imagine being a radio talk show host and developing this speaking disorder!   I look forward to learning more about this condition during my blog project.