Isolated vocal tremor as a focal phenotype of essential tremor: a retrospective case review

Journal of Clinical Movement Disorders
Amar Patel, Steven J Frucht

Abstract

Essential tremor (ET) is a common condition associated with significant physical and psychosocial disability. "Classic" ET is a clinical syndrome of action tremor in the upper limbs and less commonly the head, jaw, voice, trunk, or lower limbs. Current diagnostic criteria for ET exclude isolated vocal tremor (IVT). Failure to recognize IVT as a form of ET may contribute to misdiagnosis and missed opportunities for treatment. We conducted a retrospective review of cases referred for voice disturbance. Patients with a primary diagnosis of vocal tremor were included while those with a diagnosis of spasmodic dysphonia where excluded. 19 cases of vocal tremor were identified, of which 17 patients (89%) were female. The average age of vocal symptom onset was 64 (SD 8.0) and patients had been symptomatic an average of 6 years (SD 4) at their initial visit. 8 patients had IVT while 11 also had evidence of subtle head or limb tremor. 8 patients (42%) had a family history of ET, with vocal tremor specifically identified in 5 of those cases (26%). 11 patients (58%) noted transient tremor improvement after alcohol consumption. Primidone and propranolol were the most common medications prescribed to these patients prior to consultation. 7 p...Continue Reading

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Citations

Dec 13, 2017·Neuromodulation : Journal of the International Neuromodulation Society·Bornali KunduPaul A House
Nov 14, 2018·JAMA Otolaryngology-- Head & Neck Surgery·Cristen PaigeDavid O Francis
Jan 25, 2016·Neurological Sciences : Official Journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology·Mun Kyung SunwooKo-Eun Lee
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Oct 21, 2021·Current Opinion in Otolaryngology & Head and Neck Surgery·Sarah K Rapoport, Diana N Kirke

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