Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor

Moraes, Bruno Teixeira de; Biase, Noemi Grigoletto De

doi:10.1016/j.bjorl.2015.11.001

Cited by 15 publications

(9 citation statements)

References 20 publications

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“…This involvement does not distinguish vocal tremor of essential tremor from spasmodic dysphonia. A cross sectional study of 19 ear, nose, and throat patients with either essential tremor or dystonic tremor found that dystonic patients were more likely to have reduction of tremor in the palate (P=0.02), pharynx (P=0.038), and larynx (P=0.002) when using a higher “falsetto” pitch 36…”

Section: Clinical Manifestationsmentioning

confidence: 99%

Essential tremor: diagnosis and management

Shanker

2019

BMJ

117

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Essential tremor is one of the most common movement disorders in adults and can affect both children and adults. An updated consensus statement in 2018 redefined essential tremor as an isolated action tremor present in bilateral upper extremities for at least three years. Tremor may also be present in other locations, commonly the neck or the vocal cords. Patients with additional neurologic symptoms are now categorized as “essential tremor plus.” Additional clinical features associated with the condition include but are not limited to cognitive impairment, psychiatric disorders, and hearing loss. When treatment is needed, propranolol and primidone are considered first line treatments. Patients who are severely affected are often offered deep brain stimulation. Although the ventral intermediate nucleus of the thalamus is the traditional surgical target, the caudal zona incerta is also being studied as a possible superior alternative. Magnetic resonance imaging guided high intensity focused ultrasound is a newer surgical alternative that may be ideal for patients with substantial medical comorbidities. Current research explores novel oral treatments, chemodenervation, and noninvasive neuromodulation for treatment of essential tremor.

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Section: Clinical Manifestationsmentioning

confidence: 99%

Essential tremor: diagnosis and management

Shanker

2019

BMJ

117

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“…No que se refere ao ano de publicação dos estudos, observaram-se pesquisas que datam do início dos anos 1990 (1993 e 1994), bem como pesquisas contemporâneas referentes aos anos de 2016 e 2017 A frequência de publicações sobre o tema é limitada, considerando-se que este estudo não realizou demarcações temporais na sua busca por artigos. Os anos que apresentaram mais trabalhos foram os de 1994 e 2016, com a publicação de dois estudos por ano (Borges, Ferraz, & Andrade, 1994;Moraes & Biase, 2016;Medeiros et al, 2016). A Tabela 1 apresenta a descrição dos artigos que foram incluídos e analisados nesta revisão, demonstrando seus títulos, autores e anos de publicação das pesquisas.…”

Section: Figura 2 Resultado Da Busca Nas Bases De Dadosunclassified

“…Na discussão sobre os temas mais analisados nos estudos, destacam-se as pesquisas referentes à caracterização clínica do TE. Nesse sentido, afirma-se que costuma acometer as mãos e os antebraços dos indivíduos, podendo ou não acometer ambas as mãos, manifestando-se também em outras partes do corpo, como a cabeça (Azevedo & Meyer, 2017;Zeigelboim & Mittelmann, 2008), e provocando alterações na emissão vocal em 11% a 30% dos casos (Moraes & de Biase, 2016). Observa-se ainda que a constância dos tremores varia entre 4Hz e 12Hz, tendo evolução lenta durante os anos e apresentando comorbidades associadas (Azevedo & Meyer, 2017).…”

Section: Discussionunclassified

Tremor Essencial e Aspectos Psicológicos: Considerações sobre Estudos Insuficientes Associados

Santana

Dias

2021

PSSA

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O tremor essencial é um distúrbio do movimento que alcança até 5% da população mundial, vinculando-se a transtornos psiquiátricos e sofrimento psíquico. O presente artigo teve como objetivo identificar a produção científica brasileira sobre este tremor, considerando os aspectos psicológicos associados. Foi realizada uma revisão sistemática da literatura nacional publicada entre 1993 e 2018. As bases de dados consultadas foram SciELO, MEDLINE, LILACS e periódicos CAPES, a partir dos descritores “Tremor Essencial” e “Tremor and Essencial” e tradução para o inglês. A análise com 14 artigos identificou somente dois citando os aspectos psicológicos. Este tipo de investigação é pertinente, pois o impedimento na realização de movimentos impacta nas atividades diárias e de socialização. Os achados demonstraram a escassez de pesquisas nacionais que abordem diretamente esta relação, evidenciando a necessidade de maiores investimentos neste campo de estudo.

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“…Diagnoses were made by observing tremors that occurred during vowel production and during the tasks that separated the two types of action tremors, i.e., emission of the continuous /s/ and the whistle. Tremors were classified as essential when observed during the execution of both types of tasks and dystonic when not observed during the emission of /s/ and the whistle 5 , 6 .…”

Section: Methodsmentioning

confidence: 99%

“…Dystonic vocal tremor is phonation dependent and does not occur in non-phonated emissions. These postures and specific tasks should be evaluated by nasofibrolaryngoscopy to classify and differentiate the types of vocal tremors 5 , 6 .…”

Section: Introductionmentioning

confidence: 99%

Comparison of botulinum toxin and propranolol for essential and dystonic vocal tremors

Guglielmino

Moraes

Villanova

et al. 2018

Clinics

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OBJECTIVES:Vocal tremors, which cause social difficulties for patients, may be classified as resting or action tremors. Of the vocal action tremors, essential and dystonic tremors are the most common. Botulinum toxin and oral medications have been used to treat vocal tremors, but no comparative clinical trials have been performed. The aim of this study was to compare the effects of botulinum toxin injection and the oral administration of propranolol in the treatment of essential and dystonic vocal tremors.METHODS:This clinical trial recruited 15 patients, divided into essential and dystonic vocal tremor groups. Patients in both groups received successive treatment with botulinum toxin and propranolol. The treatments were administered at different times; the order of treatment was randomly selected. Patients were assessed with flexible nasofibrolaryngoscopy and with perceptual and acoustic voice evaluations. A statistical significance level of 0.05 (5%) was used.RESULTS:Botulinum toxin produced statistically significant improvements in perceptual measures of vocal instability in patients with dystonic vocal tremors compared with baseline values and treatment with propranolol. The acoustic measure of variability in the fundamental frequency was significantly lower in patients with dystonic vocal tremors after treatment with botulinum toxin.CONCLUSION:Essential and dystonic vocal tremors responded differently to treatment. Dystonic vocal tremors responded significantly to treatment with botulinum toxin but not oral propranolol. Essential vocal tremors did not respond significantly to either treatment, perhaps due to the small number of patients, which is a limitation of this research.

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Laryngoscopy evaluation protocol for the differentiation of essential and dystonic voice tremor

Abstract: The protocol of specific tasks by means of transnasal fiberoptic laryngoscopy is a viable method to differentiate between essential and dystonic voice tremor syndromes through the following tasks: /s/ production, continuous whistling and reduction of tremor in falsetto.

Cited by 15 publications

References 20 publications

Essential tremor: diagnosis and management

Essential tremor: diagnosis and management

Tremor Essencial e Aspectos Psicológicos: Considerações sobre Estudos Insuficientes Associados

Comparison of botulinum toxin and propranolol for essential and dystonic vocal tremors

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