Pharyngeal Dystonia Mimicking Spasmodic Dysphonia

Lucy L. Shi, C. Blake Simpson, Edie R. Hapner, Hyder A. Jinnah, Michael M. Johns

Research output: Contribution to journalArticlepeer-review

1 Scopus citations


Objective: The aim of this study was to describe the presentation of pharyngeal dystonia (PD), which can occur as a focal or segmental dystonia with a primarily pharyngeal involvement for the discussion of treatment methods for controlling consequent symptoms. PD is specific to speech-related tasks. Methods: A retrospective medical record review of four patients with PD was performed. Results: All patients were initially misdiagnosed with adductor spasmodic dysphonia and failed standard treatment with botulinum toxin type A (BTX). On laryngoscopy, the patients were discovered to have segmental or focal dystonia primarily affecting the pharyngeal musculature contributing to their vocal manifestations. A novel treatment regimen was designed, which involved directing BTX injections into the muscles involved in spasmodic valving at the oropharyngeal level. After titrating to an optimal dose, all patients showed improvement in their voice and speech with only mild dysphagia. These patients have maintained favorable results with repeat injections at 6- to 12-week intervals. Conclusions: PD, or dystonia with predominant pharyngeal involvement, is a rare entity with vocal manifestations that are not well described. It can be easily mistaken for spasmodic dysphonia. PD is specific to speech-related tasks. A novel method of BTX injections into the involved muscles results in a significant improvement in voice without significant dysphagia.

Original languageEnglish (US)
Pages (from-to)234-238
Number of pages5
JournalJournal of Voice
Issue number2
StatePublished - Mar 2018


  • Dysphonia
  • Dystonia
  • Segmental dystonia
  • Spasmodic dysphonia
  • Speech-language disorder

ASJC Scopus subject areas

  • Otorhinolaryngology
  • Speech and Hearing
  • LPN and LVN


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