Spasmodic Dysphonia

Dysphonia is the medical term for disorders of the voice. 

Spasmodic dysphonia (SD) is a neurological voice disorder that affects the voice muscles in the larynx, or voice box, causing it to “spasm.” These spasms cause the voice to be interrupted and affect voice quality. SD can cause the voice to break up or to have a tight, strained, breathy, whispery or strangled quality. It sometimes sounds like a vocal tremor. 

The condition is pronounced spaz-MOD-ic diss-PHONE-nee-yah. It is also known as laryngeal dystonia. 

Although the condition can start anytime in life, spasmodic dysphonia seems to begin more often when people are middle-aged. The disorder affects women more than men. 


There is no known cause for spasmodic dysphonia. Evidence suggests that the condition starts at the base of the brain in the basal ganglia, which regulate involuntary muscle movement. Genetic factors may put some people at greater risk of developing spasmodic dysphonia, particularly those who have family members with any form of dystonia (neurological movement disorders that cause twisting, repetitive movements or abnormal postures). 

Signs or Symptoms

Typical symptoms of spasmodic dysphonia include:

  • Voice breaks up
  • Voice sounds breathy, whispery, strangled or tight
  • Vocal tremor
  • Hoarse voice
  • Jerky voice
  • Tremulous voice
  • Intermittent voice breaks
  • Effort required to produce voice
  • Failure to maintain voice
  • Breathy voice spasms


Spasmodic dysphonia is sometimes difficult to diagnose because people with the condition often have symptoms that are similar to other voice disorders. 

The University of Michigan Vocal Health Center team will ask you about your symptoms and medical history, and then do a thorough head and neck examination. During this process, we will also assess your vocal quality, efficiency and proper speaking technique. 

We may need to do a procedure called a fiberoptic nasolaryngoscopy, which allows your physician to evaluate vocal fold structure and movement during speech and other activities. In this procedure, the physician passes a small, lighted tube through the nose and into the back of the throat. 


While there is currently no cure for spasmodic dysphonia, we have found a great deal of success with these treatments:

  • Voice therapy
  • Botox injections

In severe cases, we may recommend augmentative and alternative devices, such as devices that amplify a person’s voice in person or over the phone, or special software to translate text to speech.

When conventional treatments are not working, we may recommend surgery on the larynx. 

Make an Appointment

Schedule an appointment by calling us at (734) 936-8051.