Clinical subtypes of essential tremor

被引:93
作者
Louis, ED
Ford, B
Barnes, LF
机构
[1] Columbia Univ, Coll Phys & Surg, Gertrude H Sergievsky Ctr, New York, NY USA
[2] Columbia Univ, Coll Phys & Surg, Dept Neurol, New York, NY USA
关键词
D O I
10.1001/archneur.57.8.1194
中图分类号
R74 [神经病学与精神病学];
学科分类号
摘要
Background: There is clinical variability in essential tremor (ET), but it is not clear whether this variability is because of the existence of distinct clinical subtypes of ET (ie, forms of ET that may differ in their etiology, rate of progression, or response to treatment). Objectives: To examine in a group of ET cases the age of onset, anatomic distribution, and rate of progression of tremor, and to look for associations between these factors. Methods: Cases of ET were ascertained from a community (n=60) and a tertiary referral clinic (n=55) in northern Manhattan, New York, NY. All subjects underwent an interview and videotaped tremor examination. Rate of progression was estimated based on the tremor severity and reported disease duration at the time of evaluation. Results: Age of onset was bimodally distributed in clinic cases. There were differences in the anatomic distribution of the tremor (arm tremor only vs head and ann tremor vs isolated head tremor). Rate of progression was distributed exponentially; there was a large cluster of subjects with slower rates of progression, and a smaller number who had faster rates. There was an association between age of onset and rate of progression (r = 0.46-0.50, P<.002); cases with older age of onset (>60 years) progressed more rapidly (P<.001). In addition, upper limb tremor progressed more slowly among those with concomitant head tremor (P=.03). Conclusions: Essential tremor is not a homogeneous condition. There are differences in age of onset, anatomic distribution of tremor, and rate of progression. The ET in several groups of patients in this study (those with age of onset >60 years and those without head tremor) progressed moro rapidly, suggesting that these ET cases may define distinct clinical subtypes. These subtypes should be further assessed for etiologic and genetic heterogeneity as well as differences in responsiveness to therapeutic agents.
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页码:1194 / 1198
页数:5
相关论文
共 21 条
  • [1] ASHENHURST EM, 1973, CAN MED ASSOC J, V109, P876
  • [2] A STUDY OF HEREDITARY ESSENTIAL TREMOR
    BAIN, PG
    FINDLEY, LJ
    THOMPSON, PD
    GRESTY, MA
    ROTHWELL, JC
    HARDING, AE
    MARSDEN, CD
    [J]. BRAIN, 1994, 117 : 805 - 824
  • [3] EFFECT OF PROPRANOLOL IN HEAD TREMOR - QUANTITATIVE STUDY FOLLOWING SINGLE-DOSE AND SUSTAINED DRUG ADMINISTRATION
    CALZETTI, S
    SASSO, E
    NEGROTTI, A
    BARATTI, M
    FAVA, R
    [J]. CLINICAL NEUROPHARMACOLOGY, 1992, 15 (06) : 470 - 476
  • [4] OBSERVATIONS ON ESSENTIAL (HEREDOFAMILIAL) TREMOR
    CRITCHLEY, M
    [J]. BRAIN, 1949, 72 (02) : 113 - 139
  • [5] ESSENTIAL TREMOR - ELECTROPHYSIOLOGICAL AND PHARMACOLOGICAL EVIDENCE FOR A SUBDIVISION
    DEUSCHL, G
    LUCKING, CH
    SCHENCK, E
    [J]. JOURNAL OF NEUROLOGY NEUROSURGERY AND PSYCHIATRY, 1987, 50 (11) : 1435 - 1441
  • [6] ESSENTIAL TREMOR IN PAPUA-NEW-GUINEA
    HORNABROOK, RW
    NAGURNEY, JT
    [J]. BRAIN, 1976, 99 (DEC) : 659 - 672
  • [7] Clinical expression of essential tremor: Effects of gender and age
    Hubble, JP
    Busenbark, KL
    Pahwa, R
    Lyons, K
    Koller, WC
    [J]. MOVEMENT DISORDERS, 1997, 12 (06) : 969 - 972
  • [8] LARSSON TAGE, 1960, ACTA PSYCHIAT ET NEUROL SCAND SUPPL, V36, P1
  • [9] ESSENTIAL TREMOR - CLINICAL CORRELATES IN 350 PATIENTS
    LOU, JS
    JANKOVIC, J
    [J]. NEUROLOGY, 1991, 41 (02) : 234 - 238
  • [10] DIFFERENCES IN THE PREVALENCE OF ESSENTIAL TREMOR AMONG ELDERLY AFRICAN-AMERICANS, WHITES, AND HISPANICS IN NORTHERN MANHATTAN, NY
    LOUIS, ED
    MARDER, K
    COTE, L
    PULLMAN, S
    FORD, B
    WILDER, D
    TANG, MX
    LANTIGUA, R
    GURLAND, B
    MAYEUX, R
    [J]. ARCHIVES OF NEUROLOGY, 1995, 52 (12) : 1201 - 1205