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Article
November 28, 1990

Treatment of Speech and Voice Disorders With Botulinum Toxin

Author Affiliations

From the Speech and Voice Unit, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Md.

From the Speech and Voice Unit, National Institute on Deafness and Other Communication Disorders, National Institutes of Health, Bethesda, Md.

JAMA. 1990;264(20):2671-2675. doi:10.1001/jama.1990.03450200079035
Abstract

SELECTED CASE  A 37-YEAR-OLD woman presented to the Speech and Voice Unit of the National Institutes of Health, Bethesda, Md, with a 5-year history of a voice disorder of unknown etiology. The disorder began after an upper respiratory infection, when she developed hoarseness that persisted for several weeks. Indirect laryngoscopy 1 month after onset revealed no abnormalities: the vocal folds appeared normal and moved symmetrically. The symptoms progressed during the succeeding months; her voice became difficult to control, with frequent pitch and voice breaks. Speech therapy provided no lasting benefit. Because she had been undergoing a divorce and had a stressful job, her physician suggested psychological counseling. She discontinued counseling after a 3-month trial afforded no benefit. The symptoms progressed during the next 2 years and then stabilized, sometimes aggravated by stress and voice use. During the next few years she sought relief with hypnosis, acupuncture, and various medications, including

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