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SPASMODIC DYSPHONIA, VOICE 508

DIAGNOSIS
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INTRODUCTION
PREVENTION
SYMPTOMS
DIAGNOSIS
TREATMENT
MULTI-MEDIA EXAMPLES
BIBLIOGRAPHY
TEAM CONTACTS

What the SLP observes for diagnosis:

exam.jpg

 A team approach is most beneficial for the patient. Evaluation by a ENT is necessary. An examination by a Neurologist may be recommended as well as an SLP. The ENT would perform an analysis of structure   while the Neurologist would assess nerve damage that would be indicative of a disease in progress. A perceptual assessment would be performed by the SLP to determine if Spasmodic Dysphonia is the correct diagnosis of the patients voice disorder. The following information would be helpful for an SLP to consider while performing the evaluation. Since it is a difficult diagnosis to confirm, perceptual data is most important for an accurate diagnosis. Instrumental assessment can support the perceptual findings.  
 
 
Adductor :
The thyroarytenoids contract
with excess force causing
tight, strained and strangled
phonation.
 
Abductor :
Random opening of the vocal folds is
caused by contraction of the posterior cricoarytenoids causing a breathy and whispered voice.
 
Symptoms Of Spasmodic Dysphonia:
  • Abrupt voice breaks
  • Rarely goes away once it begins
  • Voice may be better in the morning ( SD goes away during sleep)
  • May improve when relaxed
  • Expend a lot of energy while speaking
Differentiation Between Adductor And Abductor Dysphonia :
 
ADDUCTOR SD :
  • Client won’t have problem reading a sentence with all voiced phonemes.
  • Client will have difficulty reading sentence with voiced/unvoiced phonemes.
  • Spectogram shows: abrupt voice breaks, irregular wide spaced vertical striations, high frequency noise, distinct formants.
  • While speaking, may have difficulty breathing, muscle pain in upper chest, facial grimacing, neck contractions, bulging neck muscles.
  • Tire while speaking because they are pushing their voice through a tight opening.

ABDUCTOR SD :

  • Client would have difficulty reading sentence with all voiced phonemes.
  • Client would have difficulty reading sentence with voiced/unvoiced phonemes.
  • Intermittent moments of aphonia and breathiness.
  • Most difficulty with transition from voiceless consonant to a vowel in a stressed syllable.
  • Folds approximate briefly, then abduct abruptly randomly preventing vibration and causing breathiness.
  • Clients with Abductor SD seem to tire because they are pushing so much air while phonating.
  • Abductor SD is not as common as Adductor SD.

Instrumentation procedures may be useful in gathering data for a proper diagnosis. The ENT would examine the patient's larynx and vocal folds using Laryngoscopy, Nasoendocopy and/or Videostroboscopy. The Neurologist could find a neurological cause or  disease.The information provided from these evaluations would give data to support findings from the perceptual evaluations performed by the SLP for a proper diagnosis.

Team contact for Voice 508 :
Karen Nix           PSINIX@aol.com