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Essential tremor and dystonia

R M Dubinsky1, C S Gray, W C Koller

  • 1Department of Neurology, University of Kansas Medical Center, Kansas City 66160-7314.

Neurology
|November 1, 1993
PubMed
Summary
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Dystonia and tremor frequently co-occur. This study found various tremor types associated with different dystonia forms, including essential tremor preceding dystonia onset in some cervical dystonia patients.

Area of Science:

  • Neurology
  • Movement Disorders

Background:

  • Dystonia is a movement disorder characterized by involuntary muscle contractions.
  • The co-occurrence of dystonia and tremor is observed but requires further characterization.
  • Idiopathic dystonia encompasses a range of subtypes with varying clinical presentations.

Purpose of the Study:

  • To investigate the prevalence and types of tremor in patients diagnosed with idiopathic dystonia.
  • To identify specific tremor characteristics associated with different forms of dystonia.
  • To examine the relationship between essential tremor and the onset of cervical dystonia.

Main Methods:

  • Retrospective review of patient database from the Dystonia Clinic at the University of Kansas Medical Center.
  • Inclusion criteria: patients diagnosed with idiopathic dystonia.

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  • Data extraction focused on co-existing tremor types and their relationship to dystonia subtypes.

    • Main Results:

    • Out of 296 patients with idiopathic dystonia, 24 exhibited dystonic tremor.
    • Specific associations included head-nodding tremor in cervical dystonia (20 patients), hand tremor in writer's cramp (2 patients), and arm tremor in generalized dystonia (2 patients).
    • Eight patients with cervical dystonia presented with essential tremor that predated their dystonia diagnosis.

    Conclusions:

    • Tremor is a common comorbidity in idiopathic dystonia, manifesting in various forms.
    • Dystonic tremor subtypes are associated with specific dystonia classifications.
    • The presence of essential tremor prior to cervical dystonia suggests potential shared pathophysiological mechanisms or distinct etiological pathways.