A neurological voice disorder that causes involuntary muscle spasms in the larynx during speech.

Spasmodic dysphonia is believed to be a type of dystonia, a neurological condition that causes muscles to contract involuntarily. These spasms can occur in various parts of the body—including the vocal cords.

In many cases, it appears to develop from chronic muscle tension in the voice box that gradually intensifies over time. Emotional stress and other psychological factors may also contribute to its development or aggravate symptoms. Although it is neurological in nature, it is also heavily influenced by lifestyle, emotional well-being, and patterns of voice use.

People with spasmodic dysphonia often describe their voice as sounding “strangled” or effortful. The symptoms can vary depending on the type:

Adductor spasmodic dysphonia: This is the most common type. The vocal cords close too tightly, making the voice sound tight, strained, or strangled. Speech may be interrupted by sudden breaks or difficulty getting words out.

Abductor spasmodic dysphonia: In this type, the vocal cords open too much, causing breathy, weak, or whispery voice breaks.

The condition often comes and goes, with voice quality fluctuating throughout the day or depending on emotional state and fatigue.

Treatment for spasmodic dysphonia can vary depending on the severity and type. A multifaceted, tailor-made approach is often most effective.

Voice Therapy

For milder cases or those seeking alternatives to medical interventions, voice therapy can be a powerful tool. A personalised therapy plan, guided by an experienced voice therapist, can help reduce symptoms by retraining vocal behaviours and addressing emotional or physical triggers.

• Therapy may involve different techniques depending on the individual.

• What works for one person may not be effective for another—flexibility and persistence are key.

• Addressing stress and emotional factors is often an important part of treatment.

Botox Injections

Botox can be used to temporarily paralyze the muscles that are spasming. It is more effective for adductor-type spasmodic dysphonia and often provides relief from symptoms for several months. Some people find it helpful long-term, while others may seek alternatives due to the temporary nature of the results or discomfort with repeated injections.

Combined Approach

Many people benefit from combining voice therapy with medical treatments, especially if they are motivated to understand and manage their voice holistically.

Assessment by an Ear, Nose and Throat doctor is important whenever a person has experienced voice change or loss for two weeks. In the NHS, G.Ps can refer their patients to ENT service/ department. (Most larger hospitals have an ENT department). A delay in accessing G.Ps and ENTs is common nowadays, but do persevere if your voice remains troublesome. For individuals who have private health insurance, accessing an ENT assessment is generally straightforward (your insurance company may ask you to seek a GP referral first). If you don’t have private health insurance but can self-fund, individuals can seek out a private ENT assessment without a G.P referral.

Voice therapy for spasmodic dysphonia can be booked with: