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Organic (Essential) Vocal Tremor

What is essential vocal tremor?

Essential tremor is a central nervous system disorder that is characterized by rhythmic movements (tremors) of various body parts, which can include the larynx. In some patients, the tremor may only be observed when the affected body part is being used (this is called an intentional tremor), whereas other patients will exhibit a tremor event at rest. A tremor may affect multiple body parts or only a single body part. The onset of an essential tremor is typically gradual and most often begins when a patient is in his or her 50's or 60's.

What are the symptoms of an essential vocal tremor?

Laryngeal tremor is most noticeable during prolonged vowels or sustained voicing, because the rhythm of the tremor can be easily detected during these voicing tasks. Connected speech will likely be negatively affected as well, but can often be more difficult to discern. In some cases, a tremor can be so severe that it causes voice breaks/stops similar to those found in patients with spasmodic dysphonia. Additionally, these two disorders often co-exist; however, they can be mistaken for one another if not diagnosed by a trained listener.

How is a vocal tremor treated?

Unfortunately, there is no consistent, successful treatment for an essential vocal tremor. There are various surgical management strategies (from Cymetra injections to Botox injections) that can be attempted in order to decrease a laryngeal tremor, and this may vary from patient to patient. In addition, tremor-based voice therapy may often prove helpful in order to re-train speaking patterns to help decrease a listener’s perception of a patient’s tremor and help a patient feel better understood. This will not get rid of a tremor but will likely make a patient feel more confident.