Propranolol and Botulinum Toxin for Essential Vocal Tremor
Status:
Completed
Trial end date:
2014-11-01
Target enrollment:
Participant gender:
Summary
Essential tremor is the most common adult-onset movement disorder, and essential voice tremor
is the vocal manifestation of essential tremor. While nearly all essential tremor patients
experience hand tremor, many also manifest head tremor and voice tremor. Essential voice
tremor can lead to increased vocal effort, decreased intelligibility, and misconstrued
emotional state. Only one medication, propranolol, is FDA-approved to treat essential tremor.
Propranolol is not felt to be nearly as effective for axial tremors (head, trunk, neck) as it
is for extremity tremors. However, this has not been studied with any objective assessment in
a prospective way for EVT. For patients with essential voice tremor, the limited published
data suggests that botulinum toxin has been shown to lead to functional voice improvement.
Botulinum toxin, though also not well-studied with objective voice outcomes, is a commonly
used clinical therapy for treatment of essential voice tremor. While it is used more often
for essential voice tremor than propranolol therapy, botulinum toxin also has not been
prospectively studied with validated, objective voice outcome measures. The investigators
would like to determine if propranolol has any significant effect on vocal tremor. The
investigators would also like to determine, in an objective way, the effect of botulinum
toxin on vocal tremor. If effective, propranolol would provide an affordable and non-invasive
alternative or addition to botulinum toxin injections for patients with essential voice
tremor.