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Mild and transient head tremor may sometimes be observed in otherwise tremor-free relatives of essential tremor (ET) cases, although its prevalence is unclear. A diagnostic question is whether this transient, isolated head tremor, often observed as no more than a wobble, is an early manifestation of ET or whether it is a normal finding. A direct comparison with controls is needed. Two hundred and forty-one first-degree relatives of ET cases (FD-ET) and 77 spousal controls (Co) were enrolled in a study of ET. Each underwent a detailed evaluation that included a tremor history and videotaped neurological examination. None of the enrollees reported tremor, had a prior diagnosis of ET, or had significant tremor on screening spirals. All videotaped examinations were initially reviewed by a movement disorder neurologist blinded to subject type, and among those with head tremor on examination, co-reviewed by two additional movement disorders neurologists. Twenty-six (10.8, 95% Confidence interval [CI] = 7.5-15.3%) of 241 FD-ET vs. 2 (2.6, 95% CI = 0.7-9.0%) of 77 Co had isolated, transient head tremor (odds ratio = 4.54, 95% CI = 1.05-19.57, p = 0.04). No enrollee had significant upper extremity tremor and none met inclusion criteria for ET based on the presence of upper extremity tremor. With one exception, head tremor occurred during or after phonation. It was always transient (generally a single back and forth wobble) and rare (observed briefly on one or two occasions during the videotaped examination) and had a faster frequency, lower amplitude and a different quality than voluntary head shaking. The basis for the observed isolated head tremor is unknown, but it could be an early feature of ET in ET families.Indeed, one-in-ten otherwise unaffected first-degree relatives of ET cases exhibited such tremor. To a far lesser extent it was also observed in "unaffected" controls. In both, it is likely a sign of early, emerging, undiagnosed ET, although follow-up studies are needed to confirm this. If it were ET, it would indicate that the prevalence of ET may be considerably higher than previously suspected.
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http://dx.doi.org/10.3389/fneur.2018.00570 | DOI Listing |
J Neural Transm (Vienna)
December 2024
IAB - Interdisciplinary Working Group for Movement Disorders, Hamburg, Germany.
Spasmodic dysphonia (SD) is now generally considered to be a task-specific focal dystonia. For the first time, we wanted to explore the relationship between SD and dystonia from a combined neurological and phoniatric perspective. For this, we studied 115 patients with non-psychogenic SD by a combined neurological and phoniatric evaluation.
View Article and Find Full Text PDFLab Anim
December 2024
Department of Microbiology, Tumor and Cell Biology, Karolinska Institute, Stockholm, Sweden.
For over 40 years, ivermectin has served as an effective anti-parasitic drug used in human and veterinary medicine. In laboratory animal facilities it is used prophylactically or therapeutically to maintain the health status of the colony or experimentally in studies. Although ivermectin is generally safe to use, there are reports of neurotoxicity associated with ivermectin crossing the blood-brain barrier due to overdosing or blood-brain barrier dysfunction.
View Article and Find Full Text PDFVet J
December 2024
Department of Clinical Science and Services, Royal Veterinary College, University of Hawkshead Ln, Brookmans Park, AL9 7TA Hatfield, UK.
Although tremors are common neurological presentations, there is little known about their clinical features and underlying etiologies in cats. The aim of this study was to evaluate the clinical features, and underlying diagnoses in cats with tremors. We hypothesized that the results of this study would provide clinically useful information for clinicians when evaluating cats with tremors.
View Article and Find Full Text PDFJ Neurol
December 2024
Department of Neurology, Beijing Tiantan Hospital, Capital Medical University, Beijing, China.
Background: PNPLA8 is a gene that causes an autosomal recessive mitochondrial disease characterised by microcephaly and intractable epilepsy in infants and cerebellar ataxia and limb weakness in adults. Herein, we report the clinical, muscle pathology, and brain imaging features of an adult patient with new variants of PNPLA8.
Methods: A 27-year-old Chinese woman presented with abnormal gait at age 11, remained amenorrhoeic with an infantile uterus at age 17, and presented with head and limb tremors at age 21.
NMC Case Rep J
November 2024
Department of Neurosurgery, Takeda General Hospital, Kyoto, Kyoto, Japan.
A 74-year-old woman had a lacunar infarction in the brainstem and was admitted to Takeda General Hospital for treatment. She had significant sequelae and was discharged with a Modified Rankin Scale 0. Imaging follow-up was conducted every year after discharge on an outpatient basis.
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