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Neurologic changes can involve the vocal cords and lead to voice changes. Spasmodic dysphonia (SD) and vocal tremor are two of the more common causes. These disorders can lead to “spasms” or tremors of the vocal cords which causes interruptions in speech and changes to vocal quality. These disorders may require treatment with a speech therapist, neurologist, or possible injections into the vocal cords themselves to help dampen the spasms or tremors.