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Updated: May 10, 2026
MRI-guided Focused Ultrasound Thalamotomy for Patients with Medically-refractory Essential Tremor
Published on: December 13, 2017
The "head snap": a subtle clinical feature during the finger-nose-finger maneuver in essential tremor
Eliezer J Sternberg1, Roy N Alcalay, Oren A Levy
1GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, United States of America ; Tufts University School of Medicine, Boston, Massachusetts, United States of America.
Background:
Essential tremor is characterized by several hyperkinetic movements, including arm and head tremors. We report another movement of the head in patients with essential tremor, which we term the "head snap." This was observed as a jerking motion of the head in some patients while they performed the finger-nose-finger maneuver.
Methods:
We compared the prevalence of the head snap in essential tremor patients vs. Parkinson's disease patients. We also assessed the clinical correlates of the head snap.
Results:
Ten (20%) of 50 essential tremor patients exhibited a head snap of any severity (rating ≥0.5) vs. 0 of 50 Parkinson's disease patients (p = 0.001). Patients with head snap had more severe arm tremor on Archimedes spiral drawings (p = 0.019) and were more likely to have head tremor (p = 0.03) than those without it.
Conclusions:
This sign could be a useful aid in the clinical diagnosis of tremor.
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