What is spasmodic dysphonia? The condition that makes RFK Jr sound 'strangled’

During his Senate confirmation hearing for health secretary on Wednesday (January 29), many viewers pointed out Robert F. Kennedy Jr.’s noticeably raspy voice.

His unique tone is in fact due to a rare neurological condition called spasmodic dysphonia.

Kennedy, 71, has made it known that he’s not a fan of his raspy voice, telling the Los Angeles Times in April 2024 that he “can’t stand” the sound of it.

“I feel sorry for the people who have to listen to me,” he said. “My voice doesn’t really get tired. It just sounds terrible. But the injury is neurological, so actually the more I use the voice the stronger it tends to get.”

He also told the publication: “If I could sound better, I would.”

According to Johns Hopkins Medicine, Kennedy’s condition “causes the voice to break and have a tight, strained or strangled sound.” Here’s everything we know about the voice disorder.

What is spasmodic dysphonia?

Spasmodic dysphonia can cause “involuntary voice spasms in the voice box or larynx,” according to Johns Hopkins Medicine. It’s a lifelong condition that frequently affects women between the ages of 30 and 50.

There are three different types of the condition, with the most common type being Adductor spasmodic dysphonia. This condition causes “sudden involuntary spasms that trigger the vocal cords to stiffen and slam closed.”

Abductor spasmodic dysphonia is another type of condition, which causes “sudden involuntary spasms that trigger the vocal cords to open,” per John Hopkins Medicine.

The third type of condition — mixed spasmodic dysphonia — is very rare and is a “mix of symptoms” from both abductor and spasmodic dysphonia.

What are the symptoms of the neurological condition?

Symptoms can vary based on whether the spasms cause the vocal cords to close or open. These involuntary muscle movements can cause a person’s voice to sound weak, break or have a “strained/strangled quality,” according to the National Institute on Deafness and Other Communication Disorders (NIDCD).

How is spasmodic dysphonia diagnosed?

First, a speech-language pathologist may test a person’s voice production and quality. After that, an otolaryngologist — someone who specializes in the ear, nose, and throat — will then diagnose the condition.

In addition to a physical exam, people could have their vocal folds checked through a fiberoptic nasolaryngoscopy — a procedure that examines the vocal box. The procedure involves “using a lighted tube, passed through the nose into the voice box to check movement of the vocal folds during speech,” according to Johns Hopkins Medicine.

How can spasmodic dysphonia be treated?

Although there isn’t a cure for spasmodic dysphonia, there are different ways to treat it based on the individual.

One common form of therapy to reduce symptoms is “injecting Botox directly into the affected muscles of the voice box.” Symptoms can also be managed with speech therapy.