Spasmodic dysphonia: new diagnosis and treatment opportunities.

The ability to communicate is a basic need. Spasmodic dysphonia, a rare dystonia focal to the larynx, affects the vocal muscles resulting in abnormal sound and speech production. The voice may become hoarse, strained, strangled, tremulous, whispered, or aphonic. Lack of appropriate diagnosis along with the continued use of an abnormal voice often results in frustration, anxiety, and depression. Improved diagnostic ability and unique treatment with botulinum toxin injection (Botox) are now available to patients in several large medical centers across the United States and Canada. A knowledgeable and observant health care provider can alert patients and families to the possibility of treatment for a chronic voice disturbance.