Background: Patients presenting with asymmetrical postural tremor with or without mild rest tremor may be diagnosed as having essential tremor (ET), although there is considerable diagnostic uncertainty as to the long term outcome of these patients.

Objective: In this study, retrospective observations were made on 13 patients presenting originally with asymmetrical postural tremor, initially thought to have ET based on tremor characteristics, alcohol responsiveness, and family history but who subsequently met the criteria of Parkinson's disease (PD).

Methods: The patients were observed and followed up clinically with ancillary imaging using dopamine transporter SPECT scan or levodopa challenge tests in some cases. The diagnosis at original presentation with postural tremor was made with retrospective case note review.

Results: After a variable and long latent period all patients developed additional signs suggesting a clinical diagnosis of PD although picking up an initial label of ET.

Conclusions: We suggest exercising caution regarding a diagnosis of ET in patients presenting with late onset asymmetrical postural tremor even if there is no rest tremor. Alcohol sensitivity of tremor, family history of tremor, or responsiveness to beta blockers may not be helpful in diagnosing ET in these cases and some may develop PD in the long term.

Download full-text PDF

Source
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1739293PMC
http://dx.doi.org/10.1136/jnnp.2004.046292DOI Listing

Publication Analysis

Top Keywords

postural tremor
20
asymmetrical postural
16
tremor
12
patients presenting
12
parkinson's disease
8
essential tremor
8
rest tremor
8
long term
8
family history
8
postural
5

Similar Publications

Integrating deliberate shaking into daily living: a paradoxical exercise for Parkinsonian tremor.

Disabil Rehabil

January 2025

Department of General Practice and Primary Health Care, University of Auckland, Auckland, New Zealand.

Purpose: Medication often falls short in controlling tremors in Parkinson's disease. While physical activities suggest potential benefits, current exercise regimes have limitations. This paper explores the concept of deliberate shaking as an intervention to aid exercise uptake and potentially leverage synergies between medication and physical activity.

View Article and Find Full Text PDF

Comprehensive assessment reveals numerous clinical and neurophysiological differences between MECP2-allelic disorders.

Ann Clin Transl Neurol

January 2025

Section of Pediatric Neurology and Developmental Neuroscience, Department of Pediatrics, Baylor College of Medicine, Houston, Texas, 77030, USA.

Objective: Rett syndrome (RTT) and MECP2 duplication syndrome (MDS) result from under- and overexpression of MECP2, respectively. Preclinical studies using genetic-based treatment showed robust phenotype recovery for both MDS and RTT. However, there is a risk of converting MDS to RTT, or vice versa, if accurate MeCP2 levels are not achieved.

View Article and Find Full Text PDF

Background: Essential tremor (ET) is characterized by action tremor of the arms, which can interfere substantially with daily activities. Pharmacotherapy may be ineffective or associated with side effects, and stereotactic surgery is invasive. Hence, new accessible treatment options are urgently needed.

View Article and Find Full Text PDF

Reassessing the hypothesis of essential tremor as a prodromal feature of Parkinson's disease.

Parkinsonism Relat Disord

January 2025

Department of Neurology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang, People's Republic of China. Electronic address:

View Article and Find Full Text PDF

Introduction: Assessing the severity of kinetic tremor is important in clinical and research settings. Archimedes spirals are often used to assess tremor severity. Rating tremor from spirals has been based solely on visual information.

View Article and Find Full Text PDF

Want AI Summaries of new PubMed Abstracts delivered to your In-box?

Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!