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Essential Tremor

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Neurologic and Neurodegenerative Diseases of the Larynx

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Abstract

Essential tremor (ET) is one of the most common forms of abnormal tremor, considered to be highly genetic with recent evidence of environmental toxicant contributions. ET is a chronic and progressive disease and is one of the most prevalent neurological diseases. The pooled prevalence of ET is estimated at 0.4–0.9% (all ages) and between 4.6 and 6.3% among persons aged 65 and older. Recent studies suggest ET results from neurodegenerative changes to neurons within the cerebellar cortex. Even mild forms of ET can result in significant difficulty feeding, dressing, walking, writing, and speaking. Diagnosis is heavily reliant on information obtained during the case history and physical examination with careful distinction between enhanced physiological tremor, drug-induced tremor, Parkinson’s disease, and dystonic tremor. ET may be treated by a variety of healthcare professionals including general practitioners, internists, geriatricians, neurologists, neurosurgeons, speech-language pathologists, and otolaryngologists. Although feeding problems are well documented in those with ET, dysphagia has not been well studied. Approximately one-third of individuals with ET develop a voice tremor with the majority being female. ET can affect voice and speech production due to tremor affecting midline cranial structures. Systematic evaluation of those with ET affecting voice and speech patterns should include auditory-perceptual ratings, acoustic measurement, nasoendoscopic imaging, and laryngeal electromyography. ET is treated using systemic medications, or local injection of botulinum toxin (BTX) into affected musculature. Voice tremor due to ET is most commonly treated using BTX injections, although recent studies show possible benefit from systemic medication.

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Author information

Authors and Affiliations

  1. Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA

    Julie M. Barkmeier-Kraemer

  2. Department of Communication Sciences and Disorders, University of Utah School of Medicine, Salt Lake City, UT, USA

    Julie M. Barkmeier-Kraemer

  3. Departments of Neurology and Chronic Disease Epidemiology, Yale School of Medicine and Yale School of Public Health, New Haven, CT, USA

    Elan D. Louis

  4. Division of Otolaryngology—Head and Neck Surgery, Department of Surgery, University of Utah School of Medicine, Salt Lake City, UT, USA

    Marshall E. Smith

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  1. Julie M. Barkmeier-Kraemer
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  2. Elan D. Louis
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  3. Marshall E. Smith
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Correspondence to Julie M. Barkmeier-Kraemer .

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Editors and Affiliations

  1. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of California San Diego, La Jolla, CA, USA

    Philip A. Weissbrod

  2. Division of Otolaryngology–Head & Neck Surgery, Department of Surgery, University of Wisconsin–Madison, Madison, WI, USA

    David O. Francis

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Barkmeier-Kraemer, J.M., Louis, E.D., Smith, M.E. (2020). Essential Tremor. In: Weissbrod, P., Francis, D. (eds) Neurologic and Neurodegenerative Diseases of the Larynx. Springer, Cham. https://doi.org/10.1007/978-3-030-28852-5_17

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