Vocal Tremor

Vocal tremor is a rhythmic, involuntary vibration of the larynx (voice box) that causes the vocal cords to open and shut during speech. Although the condition is primarily known to impact the intrinsic muscles of the larynx, vocal tremors can also affect the extrinsic larynx muscles as well as the diaphragm, chest wall, mouth, throat and abdomen.

What Causes Vocal Tremor?

There is no known cause that triggers vocal tremors. Although patients of any age can experience the condition, it is more prevalent in older people.

What Symptoms Are Associated with Vocal Tremor?

Symptoms of vocal tremors can range from being mild (infrequent) to severe (affecting all forms of speech and even singing) and can include:

  • Involuntary changes in sound or pitch
  • Interruptions in a patient’s ability to produce sound
  • Shaky voice

Individuals who experience vocal tremors may adopt whispering as a regular manner of communication, as it masks these symptoms. It’s also worth noting that, due to similarities in symptoms, patients are often misdiagnosed as having vocal tremors when instead they actually suffer from spasmodic dysphonia—a neurological disorder in which the larynx experiences involuntary spasms.

How is Vocal Tremor Diagnosed?

There is no specific procedure used to diagnose vocal tremor. Instead, the condition can be detected by:

  • Observing the regular movement of the vocal cords during speech
  • Videostroboscopy, which provides a slow-motion perspective for a laryngologist to examine the larynx

The presence of an essential tremor in other parts of the body, such as the hands or head, may also be an indicator that a vocal tremor exists.

How is Vocal Tremor Treated?

Although there is no cure for vocal tremor, the experienced otolaryngologists at Tampa General Hospital can provide patients with treatment that can help alleviate symptoms.

Treatment options include:

  • Botulinum toxin (Botox) injection administered into the vocal folds through the neck every three to four months
  • Voice therapy intended to provide patients with exercises and guidance that may help with vocal tremors
  • Medications designed to control the tremor, allowing for smoother speech