Robert F Kennedy Jr

Understanding Spasmodic Dysphonia: The Condition Affecting RFK Jr.'s Voice says he has a condition known as spasmodic dysphonia that causes his "terrible" voice. Here's what typically causes it, and how it's treated

Robert F Kennedy Jr

• Earlier this year, Robert F. Kennedy Jr. shared that he has a voice condition called spasmodic dysphonia that causes his "terrible" voice.
• Spasmodic dysphonia is a vocal disorder that impacts the muscles in the voice box and can make a person’s speech sound tight, strained, or breathy.
• Experts say it's unclear what causes spasmodic dysphoria, refuting Kennedy's claim that a flu vaccine was a "potential culprit" for his condition.

Robert F. Kennedy Jr. once revealed the cause of what he called his “terrible” voice: a condition called spasmodic dysphonia. 

In an April 8 article in the Los Angeles Times, the current nominee to run the U.S. Department of Health and Human Services said that he “can’t stand” the sound of his voice. “My voice doesn’t really get tired,” the 70-year-old continued, “But the injury is neurological, so actually, the more I use the voice, the stronger it tends to get.” He added, “If I could sound better, I would.”

Kennedy told the paper that he first noticed a change in his voice in 1996, when he was 42. Though he acknowledged that there’s no proof that the flu vaccine contributed to his spasmodic dysphonia, Kennedy said he views the vaccine as “at least a potential culprit.”

Here’s what to know about spasmodic dysphonia, including what causes it and how it’s treated.

What Is Spasmodic Dysphonia?

Spasmodic dysphonia, also known as laryngeal dystonia, is a vocal disorder that impacts the muscles in the larynx, or voice box. With spasmodic dysphonia, the muscles inside the vocal folds spasm and interfere with vocal fold vibrations that make sound. That can cause voice breaks during speaking and make a person’s speech sound tight, strained, or breathy.

The condition impacts about 50,000 people in North America.

“It’s not painful, per se. Not like when you get a muscle spasm in your back,” Gaelyn Garrett, MD, senior executive medical director at Vanderbilt University’s Vanderbilt Voice Center, told Health. “But it requires a lot of effort for people to use their voice when they try to communicate.”

It can also become uncomfortable for some patients to talk or even swallow if they use their voice a lot, Phillip Song, MD, director of the Division of Laryngology at Massachusetts Eye and Ear and assistant professor of otolaryngology–head and neck surgery at Harvard Medical School, told Health. “My analogy is to imagine trying to run a marathon on your arms instead of your legs,” he said. “You’re overusing these muscles tremendously.”

How Do People Get Spasmodic Dysphonia?

It’s not clear how some people develop spasmodic dysphonia, Omid Mehdizadeh, MD, an otolaryngologist (ENT) and laryngologist at Providence Saint John’s Health Center in Santa Monica, CA, told Health. “We believe it has something to do with the brain,” he said.

The condition is thought to be caused by abnormal functioning in an area of the brain called the basal ganglia, which helps to coordinate the movements of muscles throughout the body, Mehdizdeh explained.

Some people may have a genetic trait that makes them more prone to developing spasmodic dysphonia, and others may have a central nervous system injury that increases the risk of the condition, Mehdizdeh said. “Most cases have no obvious reason,” he added. 

Song agrees. “We don't quite understand the mechanics of it,” he said. 

Can the Flu Vaccine Cause It?

While Kennedy said he wasn't ruling out the flu vaccine as the cause of his vocal condition, Mehdizdeh and Garrett said they don't know of anything showing a link between the two. “I have not seen a correlation in increased incidence in people who have had vaccines,” Mehdizdeh said. Added Garrett: “I have never seen any evidence to support that.”

How Is the Condition Treated?

There are different treatment options, but the most common is injections of tiny amounts of botulinum toxin (aka Botox) directly into the affected muscles of the larynx.

This treatment is considered the “gold standard," Song said, noting that the injections help to relax the spasming vocal cords. People who get Botox injections in their vocal cords will need to come back every three to six months, he said. “Botox injections are a hard sell for some, but the safety record for Botox injections really is strong,” Song said.

Some people may also take voice therapy or use assistive devices to amplify their voice, Mehdizdeh said. In severe cases, he said, a patient may have surgery on their larynx.

People with spasmodic dysphonia have a range of severity, but they aren’t usually cured of the condition, Song said. However, he noted that the condition may improve when you have fewer demands on your voice, like after retirement.

If you’re concerned you may have spasmodic dysphonia, Garrett recommends seeing an ear, nose, and throat specialist. “Anyone that has any type of voice disorder that lasts more than two weeks with no known cause should get it checked out,” she said.

This story originally appeared on: Health News - Author:Korin Miller