Velopharyngeal Dystonia: An Unusual Focal Task-specific Dystonia?

Amar S Patel,Steven J Frucht,Lucian Sulica

doi:10.5334/tohm.353

Abstract

Background: Velopharyngeal dysfunction produces a nasal speech pattern because of the inability to close the nasal airway during speech, most often associated with anatomical abnormalities of the palate. Case Report: We describe two cases of possible velopharyngeal dystonia, a task-specific movement disorder causing a speech pattern similar to velopharyngeal dysfunction. Both patients experienced treatment response with anticholinergic medication. Discussion: Dystonia affecting speech via involvement of the pharyngeal musculature may be an unrecognized etiology of voice disorders.

Highlights

Dystonia can affect speech in myriad ways
We describe two unusual cases of possible idiopathic focal task-specific dystonia affecting speech and involving primarily the pharyngeal musculature. Both patients experienced a robust improvement with anticholinergic medication
Trihexyphenidyl was increased to 4 mg three times a day and on follow-up 3 months later he reported a 90% subjective improvement. This was reflected in his examination by improvement in hypernasal speech and reduced consonant-specific guttural dysarthria (Video segments 1 and 2)

Summary

Introduction

Oromandibular dystonia may cause forceful contractions of the mouth, tongue, or jaw to produce abnormal speech patterns. Velopharyngeal Dystonia subjective improvement in the clarity and nasal quality of his voice. Trihexyphenidyl was increased to 4 mg three times a day and on follow-up 3 months later he reported a 90% subjective improvement.

Results

Conclusion