Patient perceptions of factors leading to spasmodic dysphonia: a combined clinical experience of 350 patients

Laryngoscope. 2011 Oct;121(10):2195-8. doi: 10.1002/lary.22168. Epub 2011 Sep 6.


Purpose: Spasmodic dysphonia (SD) is an idiopathic voice disorder that is characterized by either a strained, strangled voice quality or a breathy voice with aphonic segments of connected speech. It has been suggested that environmental factors play a role in triggering the onset. Clinical observation suggests that some patients associate onset with specific events or factors while others do not. The purpose of this study was to examine a large database of SD patients to determine if specific triggers are associated with the onset of SD.

Procedures: Retrospective chart review.

Results: A total of 350 charts of patients with SD were identified and were categorized as either "sudden onset" or "gradual onset." One hundred sixty-nine recalled their circumstances surrounding onset. Forty-five percent of these patients described the onset as sudden. Patient perceptions of inciting events in the sudden onset group were identified 77% of the time and 2% of the time in the gradual onset group. The most common factors identified were stress (42%), upper respiratory infection (33%), and pregnancy and parturition (10%).

Conclusions: Thirty-five percent of SD patients perceive their disorder to have a sudden onset with identified inciting events. This prevalence raises questions regarding possible behavioral and environmental factors surrounding the onset of this disorder.

Publication types

  • Comparative Study

MeSH terms

  • Acute Disease
  • Adult
  • Age Distribution
  • Age of Onset
  • Chronic Disease
  • Cohort Studies
  • Databases, Factual
  • Dysphonia / epidemiology*
  • Dysphonia / physiopathology*
  • Dysphonia / rehabilitation
  • Female
  • Follow-Up Studies
  • Humans
  • Incidence
  • Male
  • Middle Aged
  • Pain Perception / physiology*
  • Retrospective Studies
  • Risk Factors
  • Severity of Illness Index
  • Sex Distribution
  • Voice Training*