Tremor in the voice, like it does in the rest of the body, causes rhythmic, oscillating movements. Of course, the voice affected by tremor is perceived as wobbling or wavering. Tremor is usually mild, but when it becomes severe it may cause actual interruptions in the voice. There are other things to consider that cause a halting quality in the voice. Patients who have changes in nerves and muscles that typically cause this type of wavering in the voice need to be evaluated for other causes of halting type of hoarseness.

The treatment of tremor is an exciting area in laryngology. Voice therapy is often not helpfulbecause the contractions are involuntary. Medications that treat other forms of tremor are also not usually as helpful in the voice. Botulism toxin (“Botox”) is used to treat tremor and other voice movement disorders and can have excellent results. Often this treatment needs to be repeated and “fine- tuned”.