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'Atypical' tremor

J M Henderson1, R Einstein, D M Jackson

  • 1Department of Neurology, Westmead Hospital, Sydney, Australia.

European Neurology
|January 1, 1995
PubMed
Summary
This summary is machine-generated.

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Patients with atypical tremor, Parkinson's disease (PD), and essential tremor (ET) were studied. L-dopa response differentiated PD from ET, but atypical tremor patients showed varied responses, suggesting heterogeneity.

Area of Science:

  • Neurology
  • Movement Disorders
  • Clinical Neurophysiology

Background:

  • The tremor in patients with overlapping Parkinson's disease (PD) and essential tremor (ET) features, termed 'atypical' tremor, is poorly understood.
  • Differentiating between these tremor types is crucial for accurate diagnosis and treatment.

Purpose of the Study:

  • To investigate the clinical, electrophysiological, and pharmacological characteristics of patients with atypical tremor.
  • To compare these features with those of established Parkinson's disease (PD) and essential tremor (ET) cohorts.

Main Methods:

  • A double-blind, cross-over, placebo-controlled trial involving 8 'atypical' tremor patients, 11 PD patients, and 10 ET patients.
  • Tremor assessment using accelerometry and surface electromyography (EMG).

Related Experiment Videos

  • Evaluation of tremor frequency, response to propranolol, EMG patterns (synchronous vs. alternating), and response to L-dopa/benserazide.

    • Main Results:

    • Tremor frequency and response to propranolol did not distinguish between the groups.
    • Alternating EMG activity was observed in >80% of atypical and PD patients, versus 90% synchronous EMG in ET patients.
    • L-dopa/benserazide significantly improved tremor amplitude in 38% of atypical and 27% of PD patients, but none of the ET patients, showing a significant difference between ET and PD groups.

    Conclusions:

    • While L-dopa response differentiated Parkinson's disease from essential tremor, electrophysiological and pharmacological assessments did not clearly distinguish the 'atypical' tremor group.
    • The heterogeneity within the 'atypical' tremor group likely contributes to the difficulty in precise differentiation.