W Regragui1, L Lachhab2, R Razine3, E H Ait Benhaddou4, A Benomar5, M Yahyaoui4. 1. Department of neurology B and neurogenetics, hôpital des spécialités ONO, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6444, Rabat, Morocco; Movement disorders research group, hôpital des spécialités ONO, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6444, Rabat, Morocco. 2. Department of neurology B and neurogenetics, hôpital des spécialités ONO, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6444, Rabat, Morocco; Movement disorders research group, hôpital des spécialités ONO, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6444, Rabat, Morocco. Electronic address: lamiaelachhab@hotmail.com. 3. Laboratory of biostatistics, clinical research and epidemiology, faculty of medicine and pharmacy of Rabat, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6203, Rabat, Morocco. 4. Department of neurology B and neurogenetics, hôpital des spécialités ONO, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6444, Rabat, Morocco. 5. Department of neurology B and neurogenetics, hôpital des spécialités ONO, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6444, Rabat, Morocco; Centre de recherche en épidémiologie clinique et essais thérapeutiques, faculty of medicine and pharmacy of Rabat, avenue Mohammed Belarbi El Alaoui, Souissi, BP 6203, Rabat, Morocco.
Abstract
OBJECTIVE: To report the characteristics of the most frequent tremors in a population of Moroccan patients. BACKGROUND: Tremor is the most common movement disorder. It implies a wide variety of disorders with Parkinson's disease and essential tremor being the most frequent. METHODS: A retrospective study of 148 patients with tremor referred to our movement disorders outpatient clinic was performed. Clinical features and treatment regimens were analyzed. Patients with parkinsonian tremor were excluded. RESULTS: We included 62 patients with non-parkinsonian tremor. The etiologies were as follows: essential tremor (54.8%), dystonic tremor (19.4%), tremor associated with dystonia (14.5%), enhanced physiological tremor (3.2%), cerebellar tremor (3.2%), psychogenic tremor (3.2%) and Holmes' tremor (1.6%). The characteristics of essential tremor patients were analyzed. Female patients accounted for 67.6% of patients. Mean age at the onset of tremor was 52.2 ± 16.4 years. Family history of tremor was reported in 17.6% of cases. Tremor affected the arms (94.1%), head (52.9%), voice (35.3%) and legs (8.8%). Tremor was bilateral in 87.5% but was asymmetrical in 50% of patients. Patients had postural tremor (76.5%), kinetic tremor (79.4%) and rest tremor (associated in 11.8%). Treatment relied on propranolol (88.3%), primidone (14.7%), gabapentin (14.7%), clonazepam (14.7%), alprazolam (11.8%), topiramate (5.9%) and, in one patient, radiosurgery. CONCLUSIONS: Essential tremor was the predominant diagnosis, confirming its high prevalence. There was a predominance of female patients and a peak of age at onset in the fifth and sixth decades. Asymmetry of the disease was noted in half of patients.
OBJECTIVE: To report the characteristics of the most frequent tremors in a population of Moroccan patients. BACKGROUND:Tremor is the most common movement disorder. It implies a wide variety of disorders with Parkinson's disease and essential tremor being the most frequent. METHODS: A retrospective study of 148 patients with tremor referred to our movement disordersoutpatient clinic was performed. Clinical features and treatment regimens were analyzed. Patients with parkinsonian tremor were excluded. RESULTS: We included 62 patients with non-parkinsonian tremor. The etiologies were as follows: essential tremor (54.8%), dystonic tremor (19.4%), tremor associated with dystonia (14.5%), enhanced physiological tremor (3.2%), cerebellar tremor (3.2%), psychogenic tremor (3.2%) and Holmes' tremor (1.6%). The characteristics of essential tremorpatients were analyzed. Female patients accounted for 67.6% of patients. Mean age at the onset of tremor was 52.2 ± 16.4 years. Family history of tremor was reported in 17.6% of cases. Tremor affected the arms (94.1%), head (52.9%), voice (35.3%) and legs (8.8%). Tremor was bilateral in 87.5% but was asymmetrical in 50% of patients. Patients had postural tremor (76.5%), kinetic tremor (79.4%) and rest tremor (associated in 11.8%). Treatment relied on propranolol (88.3%), primidone (14.7%), gabapentin (14.7%), clonazepam (14.7%), alprazolam (11.8%), topiramate (5.9%) and, in one patient, radiosurgery. CONCLUSIONS: Essential tremor was the predominant diagnosis, confirming its high prevalence. There was a predominance of female patients and a peak of age at onset in the fifth and sixth decades. Asymmetry of the disease was noted in half of patients.
Authors: Natalia González Rojas; Martin Cesarini; José Luis Etcheverry; Gustavo Da Prat; Tomás Viera Aramburu; Emilia Mabel Gatto Journal: Tremor Other Hyperkinet Mov (N Y) Date: 2018-06-26