Spasmodic dysphonia is a daily communication challenge. This neurological disorder, characterized by involuntary laryngeal spasms, disrupts speech fluency. However, between medical treatment and behavioral management, there is a scope to achieve a more predictable and less effortful voice.
Spasmodic dysphonia is a focal dystonia. Unlike typical voice loss, it results from a neurological “short-circuit” sending erroneous contraction commands to the vocal muscles. Two main forms are distinguished according to the direction of the spasm.
The two faces of spasmodic dysphonia
1. Adductor type: the “tight” voice
This is the most common form (approximately 80% of cases). Here, the muscles close the vocal folds with too much force at the wrong moment.
- Symptoms: The voice is jerky, “strangled,” with abrupt breaks on vowels.
- Compensations: The speaker tends to push with neck muscles to try to overcome the laryngeal “barrier.”
2. Abductor type: the “breathy” voice
Less common, this form projects the vocal folds outward, preventing sound formation.
- Symptoms: The voice suddenly becomes whispered or disappears into a breathy sound, especially on consonants like “p,” “t,” or “s.”
- Compensations: Hyperventilation or jaw tension is often observed to try to “catch” the escaping sound.
The medical pathway: botulinum toxin as a last resort
The reference treatment for this pathology is medical. Some specialists offer injections of botulinum toxin directly into the laryngeal muscles to “calm” the spasms.
Caution: This procedure must be performed exclusively by a specialized physician (ENT or phoniatrist). Due to its temporary side effects (very breathy voice or swallowing difficulties immediately after the injection), this treatment is generally considered as a last resort, when other approaches have not provided sufficient quality of life.
Spasmodic versus psychogenic dysphonia: a crucial distinction
It is common to confuse these disorders, yet their origins differ:
- Spasmodic dysphonia: Neurological. It is linked to dysfunction of the basal ganglia in the brain. The spasms are organic.
- Psychogenic dysphonia: Psychological origin. It often occurs after an emotional shock or intense stress. Although the voice is similarly altered, the vocal folds are healthy, and the disorder generally responds to an emotional therapeutic approach.
Impact on self-esteem and social life
Living with spasmodic dysphonia is exhausting. The unpredictability of the voice generates anticipatory anxiety: “Will I be able to produce this word?” This struggle erodes self-esteem and can lead to social withdrawal. Vocal coaching helps regain confidence by identifying the control levers that remain available.
Vocal coaching support: Two approaches
Vocal coaching intervenes to “clean” the vocal gesture of accumulated parasitic tensions. Depending on your type of dysphonia, the working axes differ.
For ADDUCTION dysphonia (my specialty)
This is where my support is most effective. The goal is to reduce hyperclosure through:
- Soft onset: Learning to start sound emission with a pre-phonatory airflow to prevent spasm triggering.
- Fluidity vocalizations: Using resonance exercises to stabilize the spoken voice.
- Reduction of compensations: Releasing the neck and jaw muscles that attempt to force the sound passage.
For ABDUCTION dysphonia
In this case, the work is different. As the voice “escapes,” the support focuses on:
- Airflow management: Avoiding respiratory fatigue caused by glottal leakage.
- Strengthening intent: Using targeted projection techniques to maximize the limited available vibration.
- Postural support: Providing a solid base to stabilize speech despite untimely openings.
Conclusion: No longer enduring your voice
Managing spasmodic dysphonia requires a global approach. By combining medical diagnosis with coaching focused on vocal fluidity, it is possible to reduce the impact of spasms and regain more serene communication.
