Keywords

Essential tremor, botulinum toxin

Abstract

Objectives/Hypothesis: To evaluate the relative efficacy of unilateral and bilateral injections of botulinum toxin injection (BOTOX) in the treatment of essential tremor of the voice (ETV). Study Design: Prospective open-label crossover study. Methods: Patients referred to the Neurolaryngology Clinic at Toronto General Hospital with a diagnosis of ETV were eligible for the study. Patients were sequentially as-signed to receive BOTOX as either a bilateral 2.5-U or a unilateral 15-U electromyography-guided injection, followed by the alternative injection 16 to 18 weeks later. Acoustic, aerodynamic, and nasopharyngoscopic data were collected approximately 2, 6, 10, and16 weeks after each injection. Patients were asked to provide a perceptual evaluation of BOTOX effects at the conclusion of the study. Results: Three of 10 patients demonstrated an objective reduction in tremor severity with bilateral injection, and 2 of 9 with unilateral injection. However, 8 of 10 patients wished to be re-injected at the conclusion of the study. A reduction in vocal effort appeared to be coincident with reduction in laryngeal airway resistance after BO-TOX injection. Conclusions: Using objective acoustic measures, only a small proportion of patients achieved benefit from BOTOX injection for ETV. How-ever, a majority of patients in our study benefited from a subjective reduction in vocal effort that may have been attributable to reduced laryngeal airway resistance. Key Words: Essential tremor, botulinum toxin.

Original Publication Citation

Warrick, P., Dromey, C., Irish, J., Durkin, L., Pakiam, A. & Lang, A. (2000). Botulinum toxin for essential tremor of the voice with multiple anatomical sites of tremor: A crossover design study of unilateral versus bilateral injection. Laryngoscope, 110, 1366-1374

Document Type

Peer-Reviewed Article

Publication Date

2000

Publisher

The Laryngoscope

Language

English

College

David O. McKay School of Education

Department

Communication Disorders

University Standing at Time of Publication

Full Professor

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