SPASMODIC DYSPHONIA SYMPTOMS AS INITIAL PRESENTATION OF AMYOTROPHIC-LATERAL-SCLEROSIS

A patient initially diagnosed with adductor-type spasmodic dysphonia w as referred for botulinum toxin (Botox) injections, but found on subse quent evaluation to have amyotrophic lateral sclerosis, and therefore Botox was not administered. This unique case underscores the need to d elay botulinum toxin treatments in any patient with recent onset sympt oms, and to obtain thorough motor speech and voice, otolaryngologic, a nd neurologic evaluation in all patients prior to consideration for in jection.