The total indirect and direct cost of epilepsy in the United States is estimated to be $15.5 billion yearly. This estimate is based on a reported cost of $12.5 billion in 1995 converted to 2004 dollar value using Bureau of Labor Statistics data. 4.
Many patients with adductor type spasmodic dysphonia complain of physical fatigue, tightness of the neck, back, and shoulder muscles and shortness of breath due to their efforts to phonate through the closed glottis. The severity of the symptoms of adductor spasmodic dysphonia varies within and among individuals.
Phonation As with spastic dysarthria, vocal quality may be described as harsh, strained, or strangled. Voice stoppages may occur in dysarthria associated with dystonia. Resonance Hypernasality is common. Speech When voluntary speech movements are made there is often a super-imposition of involuntary movements.