What is Spasmodic Dysphonia?

Spasmodic dysphonia, or “SD,” is a neurological disorder that results in uncontrollable tremors or spasms that interrupt speaking. It can be difficult or impossible to vocalize certain words or phrases. The disease can affect anyone, and is more common in women than men. Usually SD begins in middle age. This is most frequently isolated and affects only the vocal muscles, however, some patients may develop tremor in other parts of the body.

Can you treat Spasmodic Dysphonia or tremor?

Although there is no cure for SD today, there are treatments that help improve the quality of the voice. Botox (botulinum toxin) is the most widely used treatment, and it acts by weakening the vocal muscles. Botox injections help by reducing the vocal spasms, although they also make it more difficult to achieve a loud voice. This treatment can be easily accomplished awake in the office. Botox therapy needs to be repeated when the medicine wears off, usually every three months.

Some patients with classic adductor SD (ADSD) are candidates for surgical intervention. Selective Laryngeal Adductor Denervation-Reinnervation (SLAD-R) surgery entails cutting the nerves to the voicebox and then connecting the ansa cervicalis nerves to the voice box using microsurgical techniques. SLAD-R surgery has cured many patients of this disease, with an approximately 85% success rate. This surgery was pioneered by Dr. Gerald Berke at UCLA, who taught Dr. Feinstein this surgical technique during his residency and laryngology fellowship.

Where can I find more information?

Patients with SD and their loved ones are encouraged to visit the National Spasmodic Dysphonia Association (NSDA) at their website.

Dr. Feinstein treats patients with SD, tremor, and other voice problems in his Tarzana office.