Topography of essential tremor. (July 2017)

• Record Type: Journal Article
• Authors: Chen, Wei; Hopfner, Franziska; Szymczak, Silke; Granert, Oliver; Müller, Stefanie H.; Kuhlenbäumer, Gregor; Deuschl, Günther
• Is Part Of: Parkinsonism & related disorders. Volume 40(2017)
• Page Start: 58
• Page End: 63
• Publication Date: 2017-07
• Subjects: Essential tremor -- Topography -- Head tremor -- Voice tremor -- Tremor severity; 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.2017.04.012
• Languages: English
• ISSNs: 1353-8020

Abstract

Abstract: Introduction: Topography of tremor manifestations is poorly investigated in essential tremor. The present study explores the prevalence and clinical correlates of head and/or voice tremor in essential tremor. Methods: Out of a prospectively designed registry of 972 patients, 884 patients with definite and probable essential tremor had complete information on tremor localization. Demographic and clinical characteristics were compared among four subgroups: group A (without head or voice tremor, n = 619), B (with head but without voice tremor, n = 155), C (with voice but without head tremor, n = 47), and D (with both head and voice tremor, n = 63). Results: In our patients, total prevalence of tremor was 24.7% for head, 12.4% for voice and 7.1% for the combination of head and voice. Logistic regression analyses showed that female gender is strongly associated with head tremor, which was confirmed by an additional meta-analysis. Severe hand tremor was the only factor associated with voice tremor. Both female gender and severe hand tremor increase the odds for having the combination of head and voice tremor. For males, hand tremor severity is significantly increased among those with head and voice tremor alone and in combination, but for females only for the combination. Patients with both head and voice tremor have more frequent involvement of legs and other localizations and are less responsive to β-blockers. Conclusions: Female gender and severe hand tremor may increase the odds of head and/or voice tremor in essential tremor. The association of hand tremor severity with midline tremor is stronger for males than females. Highlights: Head and voice tremor are the second and third most common tremor localizations in a cohort of 884 patients with ET. Female gender and severe hand tremor are independently associated factors with head and voice tremor in ET. The association of hand tremor severity and midline tremors seems to be stronger for males than for females.