Clinical Overview

Voice tremor is a common and disturbing problem.  It affects quality of life, perception of intellectual credibility, and sometimes intelligibility.  There are many causes of tremor.  Optimal treatment depends upon accurate diagnosis which is accomplished best by an interdisciplinary team.  In many cases, tremor can be improved; and for some people, it can be cured.

Clinical Evaluation

Comprehensive clinical evaluation is provided by an internationally renowned voice team (laryngologists, speech-language pathologists, high-performance voice specialists, nurse clinicians and others), neurologists, neurosurgeons, neuropsychologists and other experts.  Laryngeal electromyography is performed when appropriate.  After evaluation and appropriate testing, it is usually possible to establish a diagnosis and treatment plan.

Treatment

 The most conservative treatment approach always is used first; but all treatment options are available.  Initially, treatment commonly includes medications that have been used for treatment of tremor elsewhere in the body, specialized voice therapy, treatment of any other underlying laryngeal or systemic conditions that might affect voice, and other measures.  If these treatments do not provide sufficient improvement for the needs of an individual patient, other modalities are available ranging from Botulinum toxin injection to Voice Surgery to Deep Brain Stimulator implantation, a highly effective, minimally traumatic, surgical intervention introduced for voice tremor by one of the center’s co-directors in 1999.