Spasmodic dysphonia and essential vocal tremor are neurological voice disorders that are often misunderstood and misdiagnosed. They can be mistaken for simple voice strain. Duke laryngologists -- ear, nose, and throat (ENT) doctors who specialize in voice disorders -- and speech pathologists are experts in diagnosing spasmodic dysphonia and essential vocal tremor. We offer customized treatments and therapy to help you find relief.
About Spasmodic Dysphonia
Spasmodic dysphonia causes involuntary spasms of the vocal cords (also known as vocal folds). It can make your voice sound hoarse, jerky, quivering, strangled, tight, or breathy, sometimes to the point where it is difficult to speak. The vocal spasms are due to a faulty connection between a nerve and the muscle that controls your larynx (voice box).
There are two types of spasmodic dysphonia. Some people have characteristics of both.
- Abductor spasmodic dysphonia occurs when the vocal cords spasm open, which results in a breathy voice that can sound like a whisper.
- Adductor spasmodic dysphonia occurs when the vocal cords spasm shut, which causes a strained and strangled voice.
While there is currently no cure, our laryngologists and speech pathologists can offer a combination of proven treatments and voice therapy to alleviate and manage your symptoms.
About Essential Vocal Tremor
Essential vocal tremor is also an involuntary voice disorder, and it can cause rhythmic voice shaking. The voice of someone with essential vocal tremor might sound labored, unstable, and as if they are nervous. Whereas spasmodic dysphonia specifically affects the vocal cords, vocal tremor can involve muscles in the throat and those used for breathing and articulation, such as the tongue, jaw, and palate. Some people may have both essential vocal tremor and spasmodic dysphonia, so accurate diagnosis by skilled voice experts is crucial to making sure you receive appropriate treatment.
Duke Health offers locations throughout the Triangle. Find one near you.
We will assess how you use your voice and what it sounds like. When spasmodic dysphonia or essential vocal tremor is suspected, your speech pathologist will complete a detailed evaluation of your speaking patterns, with a particular focus on the signs of spasmodic dysphonia or tremor. Your laryngologist will evaluate the role of any medical conditions that can cause voice changes, such as surgeries or recent illness. We will perform a head and neck examination and a visual examination of your voice box.
Videolaryngostroboscopy is essential for reaching an accurate diagnosis and determining the best treatment for your voice. This detailed visual exam helps us evaluate how your vocal cords vibrate while you make sounds. A tiny camera attached to a small tube called an endoscope is inserted through your nose and allows us to see your vocal cords and larynx (voice box). A flashing strobe light simulates slow motion video, and the camera captures images of your vocal cords. The exam takes about a minute. Your nose may be sprayed with topical anesthetic for your comfort.
Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2020–2021.
Why Choose Duke
A Team of Experts
Your care team will include laryngologists with advanced training and years of experience in diagnosing and treating spasmodic dysphonia and essential vocal tremor. They work closely with speech pathologists who are specially trained to evaluate and treat people with voice problems and have expertise in managing neurological voice disorders.
Latest Technology and Treatments
We use sophisticated technology designed to enhance your treatment's accuracy and effectiveness.
Because spasmodic dysphonia and essential vocal tremor are neurological conditions, we may also partner with Duke Health neurologists to ensure you receive the best therapies to minimize your symptoms and improve your voice.
Active Research to Advance Care
Our ongoing research ensures you receive the best, most up-to-date care for your spasmodic dysphonia and essential vocal tremor.