Abstract
Early Head Tremor in Essential Tremor: A Case Series and Commentary
Highlights
Head tremor is a common feature in patients with essential tremor (ET), occurring in 10.9–18.0% of ET cases in population-based studies[1,2,3] and as many as 60.6% of cases in more selected samples such as brain repositories.[4]
The movement was seen in the setting of sustained phonation, speech or reading aloud during the videotaped neurological examination (Video 1)
We present a series of seven individuals at risk for ET, each of whom has what seems to be early head tremor as a marker of a transition state evolving from normal to ET
Summary
Head (i.e., neck) tremor is a common feature in patients with essential tremor (ET), occurring in 10.9–18.0% of ET cases in population-based studies[1,2,3] and as many as 60.6% of cases in more selected samples such as brain repositories.[4]. We present a series of seven self-reportedly ‘‘unaffected’’ relatives of ET cases. These seven were clinically asymptomatic and had normal levels of arm tremor on examination, yet each evidenced a transient head wobble on examination. Total tremor score (a measure of arm tremor) ranged from 5 to 12 (i.e., mild tremor within the range of normal) The prevalence of this phenotype of early head tremor was 3.7% in one study and 23.1% in the other. These cases raise a number of broad clinical, phenotypic, and pathophysiological issues about ET
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