Essential and dystonic head tremor: More similarities than differences.

Area of Science:

• Neurology
• Movement Disorders

Background:

• Head tremor is a frequent symptom of essential tremor (ET) and cervical dystonia (CD).
• Distinguishing between ET and CD can be difficult, particularly when head tremor is the predominant symptom.

Purpose of the Study:

• To identify clinical and instrumental methods that effectively differentiate ET and CD in patients presenting with head tremor.

Main Methods:

• 65 patients (23 ET with head tremor (HT+), 21 ET without head tremor (HT-), 21 CD with dystonic head tremor) and 22 controls were evaluated.
• Standard rating scales (TETRAS, TWSTRS, SARA) and Somatosensory Temporal Discrimination Threshold (STDT) were employed.

Main Results:

• TETRAS and SARA scores were elevated in the HT+ group compared to HT- and CD groups.
• Head tremor subsided in the supine position for most HT+ and CD patients.
• STDT values were significantly higher in the HT+ group versus controls.

Conclusions:

• Tremor and ataxia scales were not effective in differentiating head tremor syndromes.
• Cessation of head tremor when supine may correlate with mild tremor scores in both groups.
• Elevated SARA scores and STDT in HT+ patients indicate potential cerebellar involvement and altered somatosensory timing requiring further study.