What is it?
Vocal tremor is neurologic disorder characterized by a rhythmic oscillation of the larynx that leads to a tremulous voice. There are a number of causes of tremor and patients often have tremor in multiple locations, not just the vocal fold level.
How is it treated?
Neurological disorders of the larynx, including vocal tremor, can be further assessed using laryngeal electromyography (LEMG), which allows neurologic assessment of the patient’s larynx during continuous speech and identification of the abnormally functioning muscles. Vocal tremor can improve with oral medications that treat other forms of tremor. Sometimes patients do not improve with oral medications or cannot tolerate their side effects, while others wish to try a more local treatment. Some patients get benefit from in-office, LEMG-guided botulinum toxin injection into specific muscles of the larynx. Patients typically require repeat injections every 2-3 months for control symptoms.