Neurological Aspects of the Patient with Spasmodic Dysphonia

J Korean Neurol Assoc > Volume 14(4); 1996 > Article

Journal of the Korean Neurological Association 1996;14(4): 940-950.

연축성 발성장애 환자의 신경학적 측면

이상복, 이명식 최홍식 김광문

연세대학교 영동세브란스 병원 신경과, 연세 뇌연구소 연세대학교 영동세브란스 병원 이비인후과, 음성 언어 의학 연구소

Neurological Aspects of the Patient with Spasmodic Dysphonia

Sang Bock, Lee, M.D., Myung Sik, Lee, M.D., Hong Shik, Choi, M.D., Kwang Moon, Kim, M.D.

Department of Neurology, Yonsei Brain Center and Otorhinolaryngology, The Institute of Logopedics and Phoniatrics, Yongdong Severance Hospital, Yonsei University College of Medicine

Abstract

Spasmodic dysphonia Is a form of focal dystonia affecting laryngeal muscles. There have been a few reports on the neurological aspects of the patient with spasmodic dysphonia. No data on the clinical courses and possible causative neurological diseases have been reported. We analysed 44 patients with spasmodic dysphonia, using a check-list of clinical symptoms and laboratory tests in a prospective manner, Forty one patients had adductor type of spasmodic dysphonia and three patients had abductor type. Five different clinical courses have been identified ; about half of the patients showed relentless progress of symptoms for many years(range 1-26 years ; mean 9.8 years) . Magnetic resonance imaging study of the brain showed abnormalities in three patients(2 had a focal lesion in the basal ganglia and 1 had multiple cerebral infarctions) . One showed acanthocytosis on electron-microscopic examination of the peripheral blood smear. Navicular tremor, low facial dyskinesla, and development of other involuntary movement at the time of onset of spasmodic dysphonia may be clues suggestive of symptomatic form of spasmodic dysphonia.