“My wife's face and neck muscles tense when trying to speak?”
About 3 1/2 years ago my wife saw an eye/ear/nose/throat doctor after a several month-long change in her voice, gravelly/raspy. He diagnosed her with spasmodic dysphonia and said her vocal chords were very tight. He recommended seeing a speech therapist, which she did and that therapy helped only slightly. She saw another specialist and he wanted to do more tests on her, but we could not afford it at the time. Her voice and stress in her face/neck started slowly worsening. After she got on medicare she went to another speech therapist for three months and he said he had done all he could and he advised her doctor that he believed she suffered from muscle tension dysphonia. Just been slowly worsening since. Her face has changed a lot from the stress she has gone through, her eyes are narrowly open because of her forcefully shutting them when she speaks and her words are tortured and forced. As her husband, and no doctor, I believe stress is to blame. She rarely smiles any more and she always smiled before. She is ashamed to be around people because of this, so our social life is not good. She won't see any doctors because she doesn't believe any one can do anything and I think she is ashamed to go. Here is the strangest part of all this......anytime I wake her from her sleep at night and start talking to her she speaks as freely and clearly as she did 4-5 years ago, every time, at least up to now. When she is up and awake it is always bad and not getting any better. I ask her how can I help and she just gets mad when I do. Her face/neck has changed so much and her eyes are usually just slits any more from all this. I want her to be better and I know she wants that too. I want my wife back. What do you think may be wrong and what do you suggest be done?
Female | 66 years old
Complaint duration: 3 1/2 years
Medications: metformin/thyroid medication
Conditions: type 2 diabetes/underactive thyroid
5 Answers
Has your wife been tested for syndromes such as Freeman-Sheldon syndrome? Speech therapist that specializes in voice and swallowing may be able to provide some improvement. Other treatments such as botox are also options.
I am so sorry that your speech-therapist said that after three months that was all he could do. Speech-therapy for voice disorders is meant to be person centered and holistic to help individuals in activities of daily living. I agree with the dx from ENT on spasmodic dysphonia, as you are also describing changes occurring in your wife's face as well. There are surgical, behavioral, and augmentative interventions that have been found helpful for people with spasmodic dysphonia.
Attached to this link is helpful information about spasmodic dysphonia and interventions that can be helpful: https://www.nidcd.nih.gov/sites/default/files/Documents/publications/SpasmodicDysphonia-508.pdf
Best of luck with everything!
Attached to this link is helpful information about spasmodic dysphonia and interventions that can be helpful: https://www.nidcd.nih.gov/sites/default/files/Documents/publications/SpasmodicDysphonia-508.pdf
Best of luck with everything!
First of all this sounds really difficult for both of you. Thank you for being able to reach out. Secondly, not knowing her entire medical history, I cannot talk on certainties. However, stress and anxiety play a large role in voice disorders. They really are very debilitating especially if you once had very active and social lives. As far as some exercises and strategies to use, consider the following:
1) I like to breathe along with the “Triangle Breathing” video on YouTube with my patients. It facilities deep breathing, and in my experience, aids in reducing anxiety.
2) Consider humming along with familiar music that brings good memories and makes her happy! Humming is great for kicking the vocal folds into gear in a natural format!
3) Continue use of any oral motor exercises that would help stretch and strengthen her lip/tongue/jaw muscles to reduce the tension. Consider consulting a physical therapist if she has reduced range of motion for her head and neck.
Please let me know if you are in need of any more suggestions! Best of luck!
1) I like to breathe along with the “Triangle Breathing” video on YouTube with my patients. It facilities deep breathing, and in my experience, aids in reducing anxiety.
2) Consider humming along with familiar music that brings good memories and makes her happy! Humming is great for kicking the vocal folds into gear in a natural format!
3) Continue use of any oral motor exercises that would help stretch and strengthen her lip/tongue/jaw muscles to reduce the tension. Consider consulting a physical therapist if she has reduced range of motion for her head and neck.
Please let me know if you are in need of any more suggestions! Best of luck!
Wow! You two have been through a lot. So, in short, I am unable to diagnose or say specifically what is going on with your wife. With that said, you have indicated that your wife has hypothyroid disease which can result in voice disorders. I would recommend seeing a Speech Pathologist that is a voice specialist. They can give you a much broader range of assistance than say a Speech Pathologist that deals with strokes. Hope this helps.
Hi, I'm sorry to hear about your wife. I recommend seeing a speech pathology specialist in voice and voice disorders. Maybe get a follow up by the ENT since it's been awhile and then a speech pathologist working on voice to help reduce the tension. Make sure the ENT and speech pathologist specialize in voice and spasmodic dysphagia. I specialize in dysphagia management.
