A new paradigm for the management of essential vocal tremor with botulinum toxin. (1st April 2013)

• Record Type: Journal Article
• Authors: Gurey, Lowell E.; Sinclair, Catherine F.; Blitzer, Andrew
• Is Part Of: Laryngoscope. Volume 123:Number 10(2013:Oct.)
• Page Start: 2497
• Page End: 2501
• Publication Date: 2013-04-01
• Subjects: Otolaryngology -- Periodicals; 617.51005
• DOI: 10.1002/lary.24073
• Languages: English
• ISSNs: 0023-852X

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="lary24073-sec-0001" sec-type="section"> <title>Objectives/Hypothesis</title> <p>1) To clarify essential voice tremor (EVT) phenomenology; 2) To report a management paradigm for essential voice tremor using botulinum toxin.</p> </sec> <sec id="lary24073-sec-0002" sec-type="section"> <title>Study Design</title> <p>Retrospective analysis of prospectively collected data.</p> </sec> <sec id="lary24073-sec-0003" sec-type="section"> <title>Methods</title> <p>Phenomenology from patients diagnosed with EVT between April 1996 and March 2012 was recorded, charted, and analyzed. A paradigm for treatment of EVT using botulinum toxin based on individualized clinical findings is discussed.</p> </sec> <sec id="lary24073-sec-0004" sec-type="section"> <title>Results</title> <p>Sixteen patients were included. Fewer than 50% patients were responsive to centrally acting oral medications. Fifteen patients analyzed had horizontal laryngeal tremor and received botulinum toxin injections to bilateral thyroarytenoid muscles. Thirteen patients had a vertical laryngeal tremor, and these patients underwent additional strap muscle injections. All patients had symptomatic improvement with reduced tremor amplitude. Dose adjustments over time depended on degree of symptomatic improvement.</p> </sec> <sec id="lary24073-sec-0005" sec-type="section"> <title>Conclusions</title> <p>Management of essential voice tremor with botulinum toxin is optimized by individualizing treatment based on the tremor phenomenology observed during clinical examination.</p> </sec> <sec id="lary24073-sec-0006" sec-type="section"> <title>Level of Evidence</title> <p>4. <italic>Laryngoscope</italic>, 123:2497–2501, 2013</p> </sec> </abstract>