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UR Medicine Speech Pathology

UR Medicine / Otolaryngology (ENT) / Speech Pathology / Our Services / Vocal Dystonia & Vocal Tremor

Vocal Dystonia & Vocal Tremor

What is a vocal Dystonia?

A dystonia is an aberrant muscle movement. Vocal dystonia specifically means aberrant movements in the muscles involved in producing voice, and is only activated during speech. Spasmodic dysphonia (SD) is one of the more common types of vocal dystonia. There are two types of SD; aDductor and aBductor SD.  

  • ADductor spasmodic dysphonia causes the vocal fold (cords) to have difficulty opening of letting go of a sound during speech resulting in a strained, strangled sounding voice with breaks.   
  • ABductor spasmodic dysphonia  causes difficulty opening the vocal folds which makes it difficult to start the next sound, resulting in a voice with breathy breaks.
  • Mixed spasmodic dysphonia is when these two types of SD co-occur.

What is tremor?

Tremor is an involuntary, rhythmic contraction of a muscle/s that cause the affected parts of the body to shake.  Tremor can be an isolated disorder for example Intention/Essential Tremor or be a symptom of other neurological disorders, for example Parkinson’s Disease.   Tremor can be treated with beta-blocking drugs, anti-seizure medications, Botox, tranquilizers or dopamine in the case of Parkinson’s.  In some cases, tremor may also be treated with placement of a Deep Brain Stimulator (DBS).

  • Vocal Tremor is rhythmic contractions in muscles of voice production resulting in shaking of the vocal mechanism which we hear as shaking in the voice. 

Speech-Language Pathology Evaluation 

Our Speech-Language Pathologists have specialty training in these conditions.

Assessment will include:

  • A detailed history collection
  • Laryngeal Function Studies consisting of computerized voice analysis and airway measures
  • Behavioral voice and communication analysis
  • Tailored assessment techniques to further assess for the presence of these conditions
  • Stimuability trials

Treatment

Vocal Dystonia Treatment

  • The gold standard treatment for vocal dystonia is Botox injections into the muscle that experiences the dystonia.   This can result in a weak or breathy voice, temporarily.  Injections typically need to be repeated every 3 to 6 months.  
  • Voice therapy is often a part of the overall treatment plan, to maximize healthy vocal function and allow patients to prolong time between injections.  

Vocal Tremor Treatment 

  • Treatment generally consists of medication, if appropriate and / or Botox injections to the vocal mechanism.  
  • Voice therapy is often a part of the overall treatment plan, to maximize healthy vocal function and allow patients to prolong time between injections. 

Additional Information