Tremor in dystonia. (August 2016)

• Record Type: Journal Article
• Authors: Pandey, Sanjay; Sarma, Neelav
• Is Part Of: Parkinsonism & related disorders. Volume 29(2016)
• Page Start: 3
• Page End: 9
• Publication Date: 2016-08
• Subjects: Dystonia -- Essential tremor -- Neurophysiology; Parkinson's disease -- Periodicals; Movement disorders -- Periodicals; Movement Disorders -- Periodicals; Nerve Degeneration -- Periodicals; Nervous System Diseases -- Periodicals; Parkinson Disease -- Periodicals; Tremor -- Periodicals; Parkinson, Maladie de -- Périodiques; Parkinson's disease; 616.833
• DOI: 10.1016/j.parkreldis.2016.03.024
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Tremor has been recognized as an important clinical feature in dystonia. Tremor in dystonia may occur in the body part affected by dystonia known as dystonic tremor or unaffected body regions known as tremor associated with dystonia. The most common type of tremor seen in dystonia patients is postural and kinetic which may be mistaken for familial essential tremor. Similarly familial essential tremor patients may have associated dystonia leading to diagnostic uncertainties. The pathogenesis of tremor in dystonia remains speculative, but its neurophysiological features are similar to dystonia which helps in differentiating it from essential tremor patients. Treatment of tremor in dystonia depends upon the site of involvement. Dystonic hand tremor is treated with oral pharmacological therapy and dystonic head, jaw and voice tremor is treated with injection botulinum toxin. Neurosurgical interventions such as deep brain stimulation and lesion surgery should be an option in patients not responding to the pharmacological treatment. Highlights: Tremor in dystonia may involve dystonic or non dystonic body parts. The onset of tremor may coincide, precede or follow the onset of dystonia. Postural and action tremor are most common in dystonia and may be mistaken for ET. Neurophysiological features are similar to dystonia but the genesis of tremor remains speculative. Treatment depends upon the site of involvement.