Essential Tremor: Voice and Head Tremor

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


Essential tremor (ET) is a monosymptomatic disorder that is most commonly characterized by a postural and kinetic tremor of the upper extremities which is often accompanied by head and voice tremor (see Chap. 23). In some patients, voice and head tremor predominate and can be the most apparent and disturbing manifestations of ET. The head tremor may be vertical (“yes-yes”), horizontal (“no-no”), rotatory, or mixed. Head tremor is rhythmic and typically continuous, showing very little change with alterations in head position. In milder cases, patients are often unaware of head tremor. Voice tremor produces tremulous and wavering speech without major dysarthria.


Botulinum Toxin Essential Tremor Cervical Dystonia Botulinum Toxin Injection Vowel Sound 
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Supplementary material

Essential Tremor-voice head tremor.mp4 (MP4 9,951KB)

The patient exhibits a mixed vertical and rotary head tremor, voice tremor, and mild finger tremor.


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    Sulica L, Louis ED. Clinical characteristics of essential voice tremor: a study of 34 cases. Laryngoscope. 2010;120:516–28.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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