One of the things that distinguishes *tremor* from Spasmodic Dysphonia, per se, is the smootheness and consistency. Usually a consistent (non-deep) *wavering* over part of the vocal range. If you map it out, you are correct...it will change based on the pitch you are speaking at or even leave completely at a high pitch. It's much less distinct/deep than the catches of SD.

My mild/moderate vocal tremors began when I was six years old and were consistently wavery throughout my growing-up years. They mostly *presented* when speaking in class or in public. Because I had a consistent (smoothe, recognizable, predictable and life-long) vocal tremor, it was difficult to determine when SD actually started. Seems it was when people started changing their reaction to my voice. 1990.

The rhythm/pace that you describe sounds relatively typical of vocal tremors...not that any of us want to have them. It's bad enough to have SD. My distinct (non-SD) vocal tremors began 35 years prior to SD but I've heard of other patients who developed tremors after symptoms of SD presented.

Intriguing question. Hope some of this info helps, in differentiating tremor from your AB/SD.

With this in mind (I'm no expert but have met a few AB'ers over the years), I imagine that tremors (wavery speech patterns) and AB/SD are difficult to differentiate as AB spasming speech patterns are relatively gentle to the ear.

I defer to other AB'ers. Bill Vanderlinde and some others are much more attuned and experienced with this subject than I am. As mentioned, it was difficult for me to figure out when my SD started since I had vocal tremors my whole life and it seemed like part of the same progression. But, my case is pure-AD (no AB or mixed or anything else) and was very nasty-sounding. So, when SD kicked in and progressed, it became easier to tell the two apart.

Sure hope you can figure this one out because I'd like to know the answer myself. Good luck. Hope some AB'ers with tremors respond. Still not sure how I would tell the difference, if the tremors started after the AB.

Since you're experienced in vocal useage, you would be much more attuned than I am in differentiating tremors from spasms and in figuring out if they are getting worse or not.

Even though I don't think my tremors got worse (couldn't tell), I know other people whose tremors have not only gotten worse but actually didn't start until their SD case established itself. Sometimes the only way to separate all this out is to see what happens during a Botox shot, since the injections don't effectively address the tremors as they address the spasms. Strangely, my surgery eliminated *BOTH* my spasms and tremors. That's made me wonder, for years, if what I thought were vocal tremors all along might have actually been mild SD.

Another one of these lovely things (our * vocal package*) which is different for each of us. Write me off the BB if you want.