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Hyperkinetic Movement Disorders
Published in Philip B. Gorelick, Fernando D. Testai, Graeme J. Hankey, Joanna M. Wardlaw, Hankey's Clinical Neurology, 2020
Morales-Briceno Hugo, Victor S.C. Fung, Annu Aggarwal, Philip Thompson
Laryngeal dystonia (spasmodic dysphonia): Onset 30–40 years.Women more commonly affected (60–80%).Family history in 12%.Vocal cord adductor dystonia (85%): Voice interrupted by glottal stops (adductor spasm).Varying pitch.Strained “strangled” speech.Vocal cord abductor dystonia (15%): Effortful whispering “breathy” voice.30% have voice tremor.20% have segmental cranial dystonia.
Structural Disorders of the Vocal Cords
Published in John C Watkinson, Raymond W Clarke, Terry M Jones, Vinidh Paleri, Nicholas White, Tim Woolford, Head & Neck Surgery Plastic Surgery, 2018
Yakubu Gadzama Karagama, Julian A. McGlashan
Spasmodic dysphonia is an uncommon and frequently overlooked condition. Traditionally it is classified as adductor, abductor, mixed and tremor and respiratory forms, although further subtypes have been described.72–74 The adductor form is characterized by a strained/strangled quality to the voice, which cuts out at the onset of phonation, while the rare abductor type (approximately 15%) is characterized by breathy breaks following consonant sounds.72, 75 Some patients present with a whispery (compensated voice) that is easier for them to use in conversation. Others have a mixed form that becomes more obvious during treatment, as the untreated form often worsens or is complicated by tremor. The spasmodic laryngeal activity can be seen by careful observation with a fibre-optic endoscope during speech.
Clinical Neuroanatomy
Published in John C Watkinson, Raymond W Clarke, Christopher P Aldren, Doris-Eva Bamiou, Raymond W Clarke, Richard M Irving, Haytham Kubba, Shakeel R Saeed, Paediatrics, The Ear, Skull Base, 2018
Another possibly related dystonic syndrome is spasmodic dysphonia, a disorder characterized by choking of the voice while speaking due to laryngeal spasm, especially on initial vowel sounds. The patient can usually whisper, hum and sing normally. During the choking phase, spasms in the face and neck muscles and blepharospasm may be observed.34 Treatment with botulinum toxin is a successful form of treatment.
Assessment of communication competence in acquired communication disorders: A systematic scoping review
Published in International Journal of Speech-Language Pathology, 2023
Danielle Aldridge, Louise Cahill, Deborah Theodoros
Two specific tools addressing functional communication in dysarthria were identified (DIP; Walshe, Peach, & Miller, 2009; FCS; Drummond & Boss, 2004) along with one tool (CPIB; Yorkston et al., 2008) validated for use with individuals with spasmodic dysphonia. The FCS (Drummond & Boss, 2004) was limited in the areas of person-specificity and context-specificity, while the DIP (Walshe et al., 2009) explored environmental context to some degree. The CPIB (Yorkston et al., 2008) was reasonably comprehensive for use with individuals experiencing spasmodic dysphonia as it explored both person-specific and context-specific situations interfering with communication competence. GAS (Kiresuk & Sherman, 1968) emerged as one of the most versatile assessment tools which could be tailored to address functional communication in any population, in both person- and context-specific ways.
An overview of the pharmacotherapeutics for dystonia: advances over the past decade
Published in Expert Opinion on Pharmacotherapy, 2022
O. Abu-hadid, J. Jimenez-Shahed
Sodium oxybate is the sodium salt of Ɣ-hydroxybutyric acid (GHB), a GABA analog [116]. Its use has been evaluated in different forms of hyperkinetic movement disorders due to its proposed mechanism of action as a weak GABAB agonist and binding to extrasynaptic GHB receptors that influence GABAA receptors [116]. However, it is unclear if other mechanisms of action may contribute [116]. Based on this proposed mechanism, sodium oxybate has been evaluated in patients with alcohol-responsive spasmodic dysphonia. All published studies in the past decade have been only blinded at the video-rater level [117,118]. An interesting study shows an additive effect of botulinum toxin and sodium oxybate on right cerebellar activity that is negatively correlated to the number of voice breaks per sentence [118].
Voice evaluation – contribution of the speech-language pathologist voice specialist – SLP-V: part A. History of the problem and vocal behaviour data, self-assessment and auditory perceptual judgement
Published in Hearing, Balance and Communication, 2021
Mara Behlau, Glaucya Madazio, Thays Vaiano, Claudia Pacheco, Flávia Badaró
Each item is investigated considering the voice usage and possible influences of vocal behaviour in the specific case. For example, when searching for signs and symptoms associated with the professional use of the voice, the list offered by Roy et al. [7] helps both the patient reflect on these aspects and the clinic improve the clinical reasoning skills. The 14 items are: hoarseness, voice tires or change in quality after short use, trouble speaking or singing softly, difficulty projecting voice, a loss of singing range, discomfort while using voice, monotone voice – monopitch, effort to talk, chronic dryness of throat, chronic soreness of throat, frequently clear throat, bitter or acid taste, swallowing difficulties, and wobbly or shaky voice. For example, hoarseness, voice tires, or changes in quality after short use and discomfort while using the voice are the three aspects most associated with a voice problem in teachers with occupational dysphonia [7,8]. High neuroticism (sensitive/nervous vs. resilient/confident individuals) and low extraversion contribute to the development of functional dysphonia; however, high neuroticism and high extraversion favour the development of vocal nodules. Spasmodic dysphonia and unilateral vocal fold paralysis patients do not present any specific psychological aspects [9].