Abstract
Essential tremor (ET) is a common movement disorder characterized by postural or kinetic tremor. We aimed to evaluate median nerve enlargement in patients with ET using ultrasonography (USG). Thirty-eight hands from 19 patients with ET and 24 hands from 13 controls underwent nerve conduction studies (NCS) and USG at the wrist. Tremor severity was measured using the Fahn–Tolosa–Marin Tremor Rating Scale (FTM-TRS). The median nerve cross sectional area (mCSA) in USG and NCS parameters were compared using ANCOVA. We evaluated the correlation between mCSA and NCS parameters or FTM-TRS scores using linear regression analysis. mCSA was significantly larger (p<0.001) and NCS parameters were different in two groups. Also, mCSA was negatively correlated with part B and C scores of FTM-TRS (p<0.001 and p = 0.039, respectively). In conclusion, median nerve enlargement with the changes of NCS parameters was observed and correlated with the severity of tremor in patients with ET.
Highlights
Essential tremor (ET) is a common movement disorder characterized by postural or kinetic tremor, and 85–95% of patients with ET exhibit involvement of the distal part of the upper extremities [1,2]
We suggest that abnormal repetitive movement of the hands may result in nerve injury and subsequent cross-sectional area (CSA) increase in patient with ET
The median nerve cross sectional area (mCSA) in patients with ET was larger than that in healthy controls based on static and nerve conduction studies (NCS) parameters; motor terminal latency, compound muscle action potential (CMAP) amplitude, sensory sensory nerve action potential (SNAP) amptlidue, and sensory velocity in the median nerve were significantly different between the patients with ET and healthy controls
Summary
Essential tremor (ET) is a common movement disorder characterized by postural or kinetic tremor, and 85–95% of patients with ET exhibit involvement of the distal part of the upper extremities [1,2]. It usually presents as a bilateral postural 8–12 Hz tremor of the hands [3,4]. Overextended repetitive movement of the distal upper extremity could result in enlargement of the median nerve at the wrist because of cumulative trauma-related injury and these injuries may lead to median neuropathy, including carpal tunnel syndrome (CTS) [5,6,7].
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