BACKGROUND: Essential tremor (ET) is the most common tremor disorder in adults. In addition to upper limbs, the tremor in ET may also involve head, jaw, voice, tongue, and trunk. Though head tremor (HT) is commonly present in patients with ET, large comparative studies of ET patients with HT (HT+) and without HT (HT-) are few. METHODS: To determine whether ET with HT is a distinct clinical subtype by comparing ET patients with and without HT, a chart review of 234 consecutive patients with ET attending the neurology clinics of the National Institute of Mental Health and Neurosciences, India, was done. A movement disorder specialist confirmed the diagnosis of ET in all patients using the National Institutes of Health collaborative genetic criteria. RESULTS: HT was present in 44.4% of the patients. Comparison between HT+ and HT- showed that the HT+ group patients: (1) were older, (2) had later onset of tremor, (3) had unimodal distribution of age at onset with a single peak in the fifth decade, (4) had more frequent voice tremor, and (5) were more likely to have mild cervical dystonia. HT was part of presenting symptoms in nearly two thirds of the ET patients and in the rest it was detected during clinical examination. CONCLUSIONS: Several demographic and clinical variables suggest that ET patients with HT have a distinct clinical phenotype.
BACKGROUND:Essential tremor (ET) is the most common tremor disorder in adults. In addition to upper limbs, the tremor in ET may also involve head, jaw, voice, tongue, and trunk. Though head tremor (HT) is commonly present in patients with ET, large comparative studies of ET patients with HT (HT+) and without HT (HT-) are few. METHODS: To determine whether ET with HT is a distinct clinical subtype by comparing ET patients with and without HT, a chart review of 234 consecutive patients with ET attending the neurology clinics of the National Institute of Mental Health and Neurosciences, India, was done. A movement disorder specialist confirmed the diagnosis of ET in all patients using the National Institutes of Health collaborative genetic criteria. RESULTS: HT was present in 44.4% of the patients. Comparison between HT+ and HT- showed that the HT+ group patients: (1) were older, (2) had later onset of tremor, (3) had unimodal distribution of age at onset with a single peak in the fifth decade, (4) had more frequent voice tremor, and (5) were more likely to have mild cervical dystonia. HT was part of presenting symptoms in nearly two thirds of the ET patients and in the rest it was detected during clinical examination. CONCLUSIONS: Several demographic and clinical variables suggest that ET patients with HT have a distinct clinical phenotype.
Authors: Aasef G Shaikh; Sinem Balta Beylergil; Laura Scorr; Gamze Kilic-Berkmen; Alan Freeman; Christine Klein; Johanna Junker; Sebastian Loens; Norbert Brüggemann; Alexander Münchau; Tobias Bäumer; Marie Vidailhet; Emmanuel Roze; Cecilia Bonnet; Joseph Jankovic; Joohi Jimenez-Shahed; Neepa Patel; Laura Marsh; Cynthia Comella; Richard L Barbano; Brian D Berman; Irene Malaty; Aparna Wagle Shukla; Stephen G Reich; Mark S Ledoux; Alfredo Berardelli; Gina Ferrazzano; Natividad Stover; William Ondo; Sarah Pirio Richardson; Rachel Saunders-Pullman; Zoltan Mari; Pinky Agarwal; Charles Adler; Sylvain Chouinard; Susan H Fox; Allison Brashear; Daniel Truong; Oksana Suchowersky; Samuel Frank; Stewart Factor; Joel Perlmutter; Hyder Azad Jinnah Journal: Neurology Date: 2020-10-12 Impact factor: 9.910
Authors: Elan D Louis; Funmi M Badejo; Ashley D Cristal; James Meyers; Nora Hernandez; Karen P Chen; Kelly V Naranjo; Jemin Park; Lorraine N Clark Journal: Tremor Other Hyperkinet Mov (N Y) Date: 2017-03-25
Authors: Elan D Louis; James H Meyers; Ashley D Cristal; Amar Patel; Sule Tinaz; Seth L Pullman; Lorraine N Clark; Ruth Ottman; Pam Factor-Litvak Journal: Front Neurol Date: 2018-07-13 Impact factor: 4.003