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Title: The occurrence, intensity, kind and type of tremor in other movement disorders

Abstract:

Tremor is the symptom most frequently co-existing with the other movement disorders. It dominates in essential tremor and Parkinson’s disease, but occurs also in many other movement disorders, e.g. focal dystonia and hereditary ataxias. The goal of this study was to establish the presence and characteristics (frequency, kind, type) of tremor co-existing with movement disorders other than essential tremor or Parkinson’s disease. The study compared tremor accompanied focal dystonia, Huntington disease, Tourette syndrome and hereditary ataxias with tremor in healthy people. The additional objective was to assess the relationship between intensity of tremor and intensity of movement disorders. In addition the study examined the feasibility of objective methods assessing the presence and characteristics of tremor co-existent with other movement disorders. The study was performed in healthy people and patients with confirmed movement disorders aged 18-80 years, who expressed the formal consent. Patients with concomitant neurological disorders or other possible causes of tremor were excluded. The presence of tremor, tremor intensity and kind (rest, postural, kinetic), for both hands were assessed in clinical examination and using three methods of objective assessment (accelerometer, graphic digitizing tablet and EMG). This enabled obtaining other parameters to characterize tremor such as tremor frequency, type (physiological tremor or essential tremor) and synchronization of agonistic and antagonistic muscles. The study was performed in 123 patients with focal and segmental dystonia, 28 patients with Huntington disease, 43 patients with hereditary ataxias, 26 patients with Tourette syndrome and 51 healthy controls. The presence of tremor was identified using objective assessment (accelerometer) in 10% of control group. Most often the tremor was mild postural, similar to physiological tremor with mean frequency about 9 Hz. The presence of tremor in dystonic patients was identified in as many as 50% by clinical assessment and about 70% in objective assessment. Most often it was postural and kinetic tremor with mean frequency about 7 Hz similar to essential tremor type. There were no differences between tremor frequency and intensity in all forms of dystonia. The presence of tremor in hereditary ataxias was observed in 40% of patients in neurological examination and in about 50% of patients in objective assessment (accelerometer). There was a significant difference between presence of tremor between patients with hereditary ataxias and control group (p=0.001). Mild postural tremor with frequency about 7 Hz predominated in patients with hereditary ataxias. In this group the similar proportion of patients (about 45%) suffered from essential tremor and other tremor types. The presence of tremor in patients with Huntington’s disease was observed in only 10% of patients similar to the control group. The occurrence of tremor in Tourette syndrome subjects was identified in about 20% of patients. The difference in presence of tremor between this group and controls wasn’t statistically significant likely due to limited number of patients. The observed tremor was mild, postural and similar to physiological tremor. In none of study groups a relationship between tremor intensity and intensity of movement disorders was observed. In conclusion, tremor co-exists with the other movement disorders in different percentage of patients with particular diseases. It appears very frequent in focal and segmental dystonia, and relatively frequent in hereditary ataxias. In both of those movement disorders the tremor is mainly mild, postural and similar to essential tremor type. Objective instrumental assessment of tremor enables its detection in an additional over 10% of patients in whom hand tremor wasn’t observed in standard clinical assessment.

Level of degree:

2 - studia doktoranckie

Degree discipline:

neurologia

Degree grantor:

Wydział Lekarski

Promoter:

Andrzej Szczudlik

Date issued:

2010

Format:

application/pdf

Identifier:

oai:dl.cm-uj.krakow.pl:797

Call number:

ZB-112124

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Access rights:

tylko w bibliotece

Location of original object:

Biblioteka Medyczna Uniwersytetu Jagiellońskiego - Collegium Medicum

Object collections:

Last modified:

Oct 7, 2019

In our library since:

Nov 21, 2012

Number of object content hits:

14

Number of object content views in PDF format

14

All available object's versions:

http://dl.cm-uj.krakow.pl:8080/publication/797

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ZB-112124 Oct 7, 2019
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