Laryngeal Dystonia

  • Justin M. Hintze
  • Christy L. Ludlow
  • David G. LottEmail author


Spasmodic dysphonia (SD) is a focal laryngeal dystonia characterized by irregular and uncontrollable voice breaks. SD is a rare condition and predominantly occurs in females in their middle decades of life. Limited case series have indicated possible risk factors associated with the occurrence of SD, including a personal or family history of other types of movement disorders, previous viral illnesses, extensive voice use, and stress. In general, most cases seem sporadic and only a few appear to be familial and genetically determined. Other possible pathophysiological mechanisms include sensory processing disturbances, reduced cortical inhibition, and neurophysiological increases in excitability in the primary somatosensory cortex. Some neuroanatomical abnormalities have also been found. Overall, SD is likely a complex neural network disorder rather than one single neuroanatomical defect.

Diagnosis of SD is frequently delayed due to the complexity and overlapping of symptoms. Diagnosis should ideally involve a multidisciplinary team and include a speech examination and nasolaryngoscopy. The mainstay of treatment for SD is repeated botulinum neurotoxin injections. Surgical options, including manipulation of the larynx either by denervation, myectomy of the thyroarytenoid muscle, or laryngoplasty, have shown variable effectiveness.


Spasmodic dysphonia (SD) Voice breaks Adductor SD Abductor SD Nasolaryngoscopy Botulinum neurotoxin injections (BoNT) Genetics Spasmodic Dysphonia Attribute Inventory (SDAI) Electromyography Surgical intervention Deep brain stimulation GABA antagonists 


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Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Justin M. Hintze
    • 1
  • Christy L. Ludlow
    • 2
  • David G. Lott
    • 1
    Email author
  1. 1.Department of Otolaryngology–Head and Neck SurgeryMayo Clinic ArizonaPhoenixUSA
  2. 2.Department of Communication Sciences and Disorders (retired)James Madison UniversityHarrisonburgUSA

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