Neurological disorder steals woman's voice

By Candice Madsen

Deseret News

Published: Saturday, Nov. 27 2010 10:11 p.m. MST

SALT LAKE CITY — When 38-year-old Cheryl Garff of Salt Lake City suddenly lost her voice, she blamed a cold. The cold went away, but the mystery of what happened to her voice has lasted for two years. Recently, however, she discovered the problem is in her brain.

"Going from a cold to something in my head, it was just like, 'You've got to be kidding me,' " Garff said.

Initially, a doctor told her she simply needed to retrain her voice after having a prolonged cold and suggested she see a speech therapist.

"I would practice my ABCs in the car. I knew my voice worked. I just couldn't get it to come out right," Garff said.

Another doctor thought acid reflux was to blame, so she had surgery.

"They thought the acid would come up and spill onto the vocal chords and cause the issues," she said. The surgery helped with the acid reflux but did not fix her voice.

Garff's good voice re-emerges occasionally. In October, she counted 10 good days out of the whole month. "I'd maybe have a voice a half a day here, a full day here. The next day, I would get up, and it would be gone again. "

Finally, she was diagnosed with spasmodic dysphonia by Dr. Marshall Smith at the?Voice Disorders Center at the University of Utah. It is the only center in the Intermountain region that diagnoses and treats the disorder.

Spasmodic dysphonia is a neurological voice disorder that involves involuntary "spasms" of the vocal cords, causing interruptions of speech and affecting voice quality. Garff's voice sounds hoarse and strangled. People often think she is sick, but she feels fine and so does her throat. However, her strained voice has caused a lot of strain in her life.

"I can't call to my children or talk very well on the phone," explained Garff. She also says she feels isolated. "At work, I try to be an outgoing type of person, but half the time, I sit back and don't say anything, because my voice doesn't get heard."

Smith says while SD is uncommon, it's not rare. About 40,000 people in the United States are estimated to be affected. "SD is confused with other voice problems by clinicians who do not see the problem frequently, so it can be misdiagnosed or delayed in diagnosis," he said.

The exact cause of SD is unknown, and there is no cure. Smith says the most effective treatments are Botox injections. They?help relax the muscles to improve the quality of the voice, but the results are unpredictable and vary for each patient.

Garff will begin getting injections next month. She is cautiously hopeful the treatments will help her. "It scares me. I could be dealing with this the rest of my life."

More information on spasmodic dysphonia is available online at utahvoice.org and dysphonia.org.

e-mail: cmadsen@ksl.com

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