Abstract
Summary Evidence to date indicates that spasmodic dysphonia (SD) is a focal dystonia of the larynx, probably due to an abnormality of neurotransmitters in basal ganglia. A careful neurological examination is required to rule out other neurologic processes with similar vocal symptoms, such as Parkinsonism or pseudobulbar palsy. Signs of diseases known to cause secondary dystonia should also be sought. Patients with SD also often have other dystonias or essential tremor. Any other neurologic signs suggest that the dystonia is secondary. Without such associated neurologic findings, extensive testing including magnetic resonance imaging (MRI) is not likely to result in clinically useful information.
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