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Selma Blair reveals that her MS has led to spasmodic dysphonia



Last October, actress Selma Blair revealed that what she had originally considered a problem with a pinched nerve was actually Multiple Sclerosis (MS). Now, in her first television interview since she received her diagnosis, Blair said she also had spasmodic dysphonia, a neurological voice disorder.

"Since the birth of my son, I was in an MS outbreak and did not know you, and I've given everything to be normal," Blair said in an interview Good Morning America [1

9659004] on Tuesday. She also explained that for years she had chronic pain and was "self-medicated" drinking alcohol to cope with it. (Blair celebrated two years of sobriety in June 2018 .)

But when she finally received her diagnosis, Blair cried. "It was not tears of panic, it was tears to know that now I had to submit to a body that had lost control, and that was a bit relieved," she explained. She added that she was "very happy" to do the interview and "testify what it's like to be in the midst of an aggressive form of multiple sclerosis."

Blair also admitted that her voice was different and strangely wobbly, a change she attributed to a condition called spasmodic dysphonia.

Spasmodic dysphonia is a disease affecting the muscles of the larynx.

You have two vocal folds (or cords) that stretch out thin muscle fiber tracts. Attach both sides of your larynx (voice box) and at one end, Dr. Lee Akst, director of the Johns Hopkins Voice Center, told SELF. When opened, they form a V-shape. When you speak, the muscles squeeze them tight so they touch lightly and air that comes out of your lungs pushes them apart. The resulting vibrations form the basis of your voice, explains dr. Akst.

In the most common type of spasmodic dysphonia, the neurological signal that coordinates muscle contraction causes spasms that compress the vocal folds too tightly. to the point that air can not get through, Dr. Akst. This causes a specific speech pattern characterized by tense chatter (referred to as "staccato breaks").

Although spasmodic dysphonia may occur suddenly, those who experience a more gradual progression are more prone to speaking at first, which can lead to some roughness or roughness. Finally, the classic staccato pattern of speech develops, in which the language abruptly ceases and begins again. (There are other types of spasmodic dysphonia that cause the vocal cords to remain open and not remain closed or cause them to remain open or closed, but these are, according to the National Institutes of Health (NIH).)

The exact cause of spasmodic dysphonia is not fully understood. The current view, however, is that the abnormal function of neurotransmitters in the basal ganglia, the part of the brain responsible for coordinating involuntary movements, including those involved in speech and swallowing, is the physiological root of the disease. The NIH declares .

Symptoms of spasmodic dysphonia may progressively occur for unknown reasons, or due to another problem, such as an upper respiratory tract infection, intubation during surgery, or a kind of voice trauma, suddenly appear cord area, Dr. Akst. However, it is not always clear if these types of events are directly responsible for the disease or not.

Genetics may also play a role in some cases, according to the NIH.

Vocal changes like these are indeed something rare MS.

"MS is an autoimmune disease in which the immune system attacks the nervous system – the brain, the spinal cord, the optic nerves." Dr. Robert Bermel, neurologist at the Cleveland Clinic's Mellen Center for Multiple Sclerosis, says SELBST. "And the symptoms a patient has are directly related to where the seizures occur in the nervous system."

Technically, spasmodic dysphonia is a disorder that occurs by itself, not as a result of another condition such as MS, Dr Akst says. However, if a patient with MS has vocal changes characteristic of spasmodic dysphonia, this indicates that "the MS affects the same area of ​​the brain" that is the cause of spasmodic dysphonia. Akst in relation to the basal ganglia.

People with MS lesions in other parts of their brain, such as The cerebellum, for example, may show other types of voice changes, Dr. For example, Bermel may not be able to land at the correct pitch, or a voice that sounds as if she was plummeting to Lot, which is characteristic of a neurological symptom [Ataxia . Akst says he could expect the overall projection to be weaker, pronunciation or tempo to change, or that the overall voice of patients with MS be thin.

To diagnose these conditions, these different qualities and the careful interception of the symptoms must be examined, usually a stroboscopy, a procedure in which a camera is inserted through the patient's nose to check the vocal cords and exclude other conditions that could be responsible for the changes (such as polyps). Dr. Bermel says that the entire picture of the symptoms must also be examined. For example, if someone has a voice problem in addition to muscle weakness or blurred vision, this is an indicator that he or she is dealing with an underlying neurological disorder such as MS.

The treatment focuses on treating the symptoms.

Treating spasmodic dysphonia does not cure the condition, it can really only treat the symptoms. Some patients with spasmodic dysphonia are successful with speech therapy, which helps them to develop compensatory strategies without, however, addressing the underlying physiological problems. Akst. Other patients may opt for Botox injections into the vocal cords (through the neck), which weakens the muscles and prevents them from clinging so tightly. (If Botox injections help a patient, this is even more a confirmation that the diagnosis is correct, notes Dr. Akst.)

When spasmodic dysphonia is associated with MS, medications may be used to treat spasms throughout Body, z. Also help with spasmodic dysphonia, says Dr. med. Bermel. In these cases, patients may find that their voice changes worsen with a flare and then, as with many MS symptoms, get better.

Above all, the correct diagnosis and a treatment plan for the individual case are crucial. Because MS can present in so many different ways, it's important to have "an individual approach to each person's disease," says Dr. Bermel.

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