Speech is the prominent way of communication among humans. It needs proper training from childhood to listen understand and speak. Speaking skills are modified through many adaptive changes by generations. It needs a gradual & steady development of structures associated with speech from the foetus. F After birth, in childhood the language is grasped from the surrounding people as a part of growing up. Both physical and emotional factors play a role in the proper functioning of organs of speech. Any abnormality in any of these can lead to various kinds of speech disorders.
Spasmodic dysphonia (SD) is a chronic voice disorder, that is characterized by excessive or inappropriate contraction of laryngeal muscles during speech.
Signs and symptoms
Speech is characterized by strained or strangled phonation with intermittent voice offsets on voicing of vowels. Patients report that symptoms are worse when they are under emotional stress, when they talk on the telephone, or when they speak in public. The symptoms are often better upon awakening in the morning or after a drink of alcohol. Abductor spasmodic dysphonia (SD) is rarer than the adductor type (17% of all patients with spasmodic dysphonia). Patients have prolonged voiceless consonants because of difficulties with voice onset following voiceless sounds such as /h/, /s/, /f/, /p/, /t/, and /k/. Additional symptoms in some patients with abductor spasmodic dysphonia (SD) include pitch changes, phonatory breaks during vowels, uncontrolled rises in vowels’ fundamental frequency, or a breathy voice quality.
Causes
Genetic disorder which has been attributed to a defect on bands 9q32-34.
Pathophysiology
Spasmodic dysphonia (SD) is currently understood to be a focal dystonia that affects laryngeal muscle control during speech. Dystonia refers to a syndrome of sustained muscle contractions. Focal dystonias involve abnormal activity in only a few muscles. Dystonic movements are aggravated or become manifest during voluntary movement and worsen with fatigue or physical and emotional stress. Dystonia may be focal, segmental, multifocal, or generalized. Although spasmodic dysphonia (SD) is considered a focal dystonia, it may present as a segmental or multifocal dystonia.
Diagnosis
Videolaryngostroboscopy
Neurologic examination
Perceptual analysis
Acoustic analysis
Aerodynamic analysis
Electromyographic analysis
Subjective evaluation by patient
Treatments
Injection of very small doses of botulinum toxin into laryngeal muscles
Prognosis
With the exception of dysphonia caused by stroke for which there can be marked improvement, dysphonia from other causes is stable or progressive, and the prognosis depends on the underlying cause, its tendency to progress, the availability of therapy, and the response to therapy.
Complications
Malnutrition
Aspiration pneumonia
Choking
Disease & Ayurveda
Voice disorders are mentioned as swarasaada or swarabheda in Ayurveda. Considering the clinical manifestations, spasmodic dysphonia can be compared with medoja swarasaada.
Nidana
Rajayakshma
Purvaaroopa
Not mentioned
Samprapti
Due to causative factors, the doshas get vitiated in the rajayakshma patient, travel in the body, get lodged in the throat(kantha) and produce the disease.
Lakshana
Kantham limpan iva – coated feeling inside the throat
Manda swara – feeble voice
Khurakhurayate – hoarse or rough voice
Vibaddha – voice production is not continuous
Kricchralakshyakshara – unclear speech, can not be identified clearly
Divisions
` Vaatika
Paittika
Slaishmika
Saannipaatikam
Kshayajam
Medojam
Prognosis
Asaadhyam – incurable
Chikithsa
It is mentioned as incurable.
Commonly used medicines
Kanchanaraguggulu
Varasanadi kashayam
Rasnadi choornam
Brands available
AVS Kottakal
AVP Coimbatore
SNA oushadhasala
Vaidyaratnam oushadhasala
Home remedies
No home remedy is proven to cure spasmodic dysphonia
Diet
- To be avoided
Heavy meals and difficult to digest foods – cause indigestion.
Junk foods- cause disturbance in digestion and reduces the bioavailability of the medicine
Carbonated drinks – makes the stomach more acidic and disturbed digestion
Refrigerated and frozen foods – causes weak and sluggish digestion by weakening Agni (digestive fire)
Milk and milk products – increase kapha, cause obstruction in channels and obesity
Curd – causes vidaaha and thereby many other diseases
- To be added
Light meals and easily digestible foods
Green gram, soups, honey
Freshly cooked and warm food processed with cumin seeds, ginger, black pepper, ajwain etc
Behaviour:
Protect yourself from cold climate.
Better to avoid exposure to excessive sunlight wind rain or dust.
Maintain a regular food and sleep schedule.
Avoid holding or forcing the urges like urine, faeces, cough, sneeze etc.
Avoid sedentary lifestyle. Be active,
Yoga
Regular stretching and mild cardio exercises are advised. Also, specific yogacharya including naadisuddhi pranayama, bhujangaasana, pavanamuktasana is recommended.
Regular exercise helps improve bioavailability of the medicine and food ingested and leads to positive health.
Yoga can maintain harmony within the body and with the surrounding system.
Yoga for dysphonia
Pavanamuktasana
Nadisudhi pranayama
Bhujangasana
Simple exercises for lungs and heart health
All the exercises and physical exertions must be decided and done under the supervision of a medical expert only.
Research articles
https://pubmed.ncbi.nlm.nih.gov/18922334/
These statements have not been evaluated by the Food and Drug Administration, United States. This product is not intended to diagnose, treat, cure or prevent any disease. Please consult your GP before the intake.
Expert,
Ayurveda Medicine, India
Writer:
Dr. Rajesh Nair, the co-founder and chief consultant of Ayurvedaforall.Com, is a graduate of prestigious Vaidyaratnam Ayurveda College (affiliated with the University of Calicut), Kerala, India. Additionally, he holds a Postgraduate Diploma in Yoga Therapy from Annamalai University.
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