Diagnosing Spasmodic Dysphonia

Spasmodic dysphonia (SD) can be difficult to diagnose because the anatomy of the larynx remains normal. SD has no objective pathology that is evident through x-rays or imaging studies like a CT or MRI scan, nor can a blood test reveal any abnormality.   As a result, a process of elimination is usually used to diagnose SD.

Adductor versus Abductor SD

Spasmodic dysphonia is generally categorized into two primary forms, adductor (AdSD) and abductor (AbSD) spasmodic dysphonia.

Symptom Checklist

Several other voice disorders may mimic or sound similar to SD. The excessive strain and misuse of muscle tension dysphonia (MTD), the harsh strained voice of certain neurological conditions, the weak voice symptoms of Parkinson’s disease, certain psychogenic voice problems, acid reflux, or voice tremor are often confused with SD. Because of the difficulty in diagnosis, we are sharing an unofficial checklist of symptoms, by disorder.  This is not intended to be an all-inclusive list, but provides guidance to shorten the time between symptom onset and diagnosis.  The designation of the patient’s predominant symptom category will be based on how many of the attributes are checked for each category. 

JAMA Otolaryngol Head Neck Surg. 2018 Aug; 144(8): 657–665.