scholarly journals Clinical and Electromyographic Examinations of Patients with Essential Tremor

Author(s):  
Ivan Milanov

ABSTRACT:Background:It is believed that no clinical differences exist among essential, familial and senile tremor, or between the tremor with synchronous or alternating electromyographic activity. The aim of this study was to evaluate the clinical and electromyographic findings in a large group of patients with different types of essential tremor.Methods:Two hundred and twenty patients with sporadic, familial or senile variants of essential tremor were examined. According to the electromyographic activity recorded from the antagonistic muscles, the patients were subdivided into a group with synchronous (SYN) and a group with alternating (ALT) activity. The historical aspects of the disease were noted, and a detailed neurological examination was performed.Results:A widespread tremor involving upper and lower limbs and 3-4 different anatomical regions was typical for familial tremor. It also had higher amplitude than the sporadic and senile tremor. ALT tremor had a higher amplitude and longer burst duration than SYN and more often involved lower limbs. Rest tremor was common in the ALT group. Overall, ALT tremor was more common than previously supposed.Conclusion:The familial and ALT tremors are more disabling than other types of essential tremor. Since electromyographic ALT activity is common in essential tremor, its presence does not reliably distinguish essential and Parkinsonian tremor.

2004 ◽  
Vol 357 (3) ◽  
pp. 187-190 ◽  
Author(s):  
Gertrúd Tamás ◽  
László Pálvölgyi ◽  
Annamária Takáts ◽  
Imre Szirmai ◽  
Anita Kamondi

2011 ◽  
Vol 2 (1) ◽  
pp. 41-46
Author(s):  
I I Katelnitsky ◽  
S A Pleskachev ◽  
M A Burikov ◽  
A S Matsionis ◽  
P E Povilaytite

The aim of the investigation was to study the morphological condition of blood cells in the basins of the ischemic limbs and their dynamics as a result of various types of surgical treatment. Implementation of combined surgical treatment has a more normalizing effect in comparison with isolated reconstructive surgical treatment. The use of lumbar sympathectomy in patients with occlusive lesions of arteries of lower limbs and varying degrees of ischemia reduces endothelial dysfunction and normalizes a number of parameters describing the morphology and functioning of red blood cells and platelets. There was detected the deformation of red blood cells indicating that the restoration of the plasticity of red blood cell membranes significally reduced the degree of agglutination of red blood cells. According to obtained data the influence of sympathectomy depends on the severity of the disease in general the highest efficiency is observed at the II and III degree of ischemia.


2019 ◽  
Vol 21 ◽  
Author(s):  
Hao Deng ◽  
Shan Wu ◽  
Joseph Jankovic

Abstract Essential tremor (ET) is a neurological movement disorder characterised by bilateral limb kinetic/postural tremor, with or without tremor in other body parts including head, voice and lower limbs. Since no causative genes for ET have been identified, it is likely that the disorder occurs as a result of complex genetic factors interacting with various cellular and environmental factors that can result in abnormal function of circuitry involving the cerebello–thalamo–cortical pathway. Genetic analyses have uncovered at least 14 loci and 11 genes that are related to ET, as well as various risk or protective genetic factors. Limitations in ET genetic analyses include inconsistent disease definition, small sample size, varied ethnic backgrounds and many other factors that may contribute to paucity of relevant genetic data in ET. Genetic analyses, coupled with functional and animal studies, have led to better insights into possible pathogenic mechanisms underlying ET. These genetic studies may guide the future development of genetic testing and counselling, and specific, pathogenesis-targeted, therapeutic strategies.


2013 ◽  
Vol 6 ◽  
pp. CCRep.S11903 ◽  
Author(s):  
Robert Fekete ◽  
Jin Li

We present clinical features and tremor characterization in a patient with Parkinson's disease (PD) as well as in two cases of essential tremor (ET) with some parkinsonian features but no evidence of dopaminergic terminal loss on 123I-FP-CIT Single Photon Emission Computed Tomography (SPECT). Relatively slow frequency rest tremor and bilateral upper extremity bradykinesia without decrementing amplitude were observed in the ET cases, with unilaterally decreased arm swing in case 3. Alternating rest tremor and re-emergent tremor with 13 second latency was confirmed in the PD case. Re-emergent tremor had alternating characteristics, which to our knowledge has not been previously reported. The ET cases had synchronous postural tremor. Alternating re-emergent tremor in PD provides further evidence for re-emergent tremor as an analogue of rest tremor in PD. Two cases of ET with synchronous postural tremor and one to two year history of parkinsonian features had no evidence of dopaminergic terminal loss up to 40 years after the initial onset of ET. Tremor synchronicity characterization can assist in differential diagnosis between the two disorders.


Sensors ◽  
2019 ◽  
Vol 19 (19) ◽  
pp. 4246 ◽  
Author(s):  
Lazar Berbakov ◽  
Čarna Jovanović ◽  
Marina Svetel ◽  
Jelena Vasiljević ◽  
Goran Dimić ◽  
...  

Tremor is most common among the movement disabilities that affect older people, having a prevalence rate of 4.6% in the population older than 65 years. Despite this, distinguishing different types of tremors is clinically challenging, often leading to misdiagnosis. However, due to advances in microelectronics and wireless communication, it is now possible to easily monitor tremor in hospitals and even in home environments. In this paper, we propose an architecture of a system for remote health-care and one possible implementation of such system focused on head tremor monitoring. In particular, the aim of the study presented here was to test new tools for differentiating essential tremor from dystonic tremor. To that aim, we propose a number of temporal and spectral features that are calculated from measured gyroscope signals, and identify those that provide optimal differentiation between two groups. The mean signal amplitude feature results in sensitivity = 0.8537 and specificity = 0.8039 in distinguishing patients having cervical dystonia with or without tremor. In addition, mean signal amplitude was shown to be significantly higher in patients with essential tremor than in patients with cervical dystonia, whereas the mean peak frequency is not different between two groups.


2019 ◽  
Vol 12 (9) ◽  
pp. e231094 ◽  
Author(s):  
Sara Teixeira ◽  
Joana Caldeira Santos ◽  
Marta Vila Real ◽  
Fátima Santos

Anti-N-methyl D-aspartate receptor (NMDAR) encephalitis is a devastating disease, that despite being increasingly diagnosed, there are no consensus guidelines for the optimal management. A previously healthy 3-year-old-boy brought to the emergency department due to seizures. Neurological examination was normal, and electroencephalogram (EEG) suggested focal epilepsy. Anticonvulsive medication was initiated. He progressively lost age-appropriate language skills, presented behavioural changes and psychiatric symptoms. Neurological examination at that time revealed symmetric gross motor weakness of the lower limbs. Brain and spinal cord MRI and cerebrospinal fluid were normal. Repeated EEG showed global lentification. Steroid therapy was initiated for the suspicion of autoimmune encephalitis, later confirmed as NMDAR encephalitis. He became clinically improved after 10 days of treatment but only returned to his baseline after 3 months of disease onset. The authors emphasised the variable course of the disease and possible late response to treatment.


2007 ◽  
Vol 73 (1) ◽  
pp. 6-9
Author(s):  
Ahmed Shafik ◽  
Olfat El Sibai ◽  
Ismail A. Shafik ◽  
Ali A. Shafik

The authors investigated the hypothesis that partial fecal incontinence (PFI) had variable manifestations that can be categorized as different types of PFI with different pathogeneses and treatment. Anal and rectal pressures as well as external and internal anal sphincter electromyographic activity were recorded in 163 patients with PFI and in 25 healthy volunteers. Patients were treated with biofeedback or surgically. Three types of PFI were encountered: stress fecal incontinence (SFI; 55 patients), urge fecal incontinence (UFI; 72 patients), and mixed fecal incontinence (MFI; 36 patients). Anal pressure decreased in three groups in which MFI had the lowest pressure. A significant reduction in external anal sphincter electromyographic activity occurred in SFI, in internal anal sphincter electromyographic activity in UFI, and of both sphincters in MFI. Bio-feedback cured 36 of 55 patients and postanal repair cured 10 of 19 patients with SFI. Forty-eight of 72 patients with UFI responded to biofeedback and 16 of 24 responded to internal anal sphincter repair. Biofeedback failed in MFI patients. Twenty-four of 27 patients who consented to operative correction of the sphincteric defect were cured. Three types of PFI could be identified: SFI, UFI, and MFI. Each type has its own etiology and symptoms, and requires individual treatment. Biofeedback succeeded in treating the majority of SFI and UFI patients. Surgical correction of the anal sphincter was performed after biofeedback failure.


Medicina ◽  
2020 ◽  
Vol 56 (10) ◽  
pp. 552
Author(s):  
Silvijus Abramavičius ◽  
Mantas Venslauskas ◽  
Antanas Vaitkus ◽  
Vaidotas Gudžiūnas ◽  
Ovidijus Laucius ◽  
...  

Background and objectives: tremor is an unintentional and rhythmic movement of any part of the body that is a typical symptom of Essential Tremor (ET). ET impairs the quality of life of patients and is treated with pharmacotherapy. We investigated the tremor reduction efficacy of an innovative vibrational medical device (IMD) in ET patients. Materials and Methods: we conducted a prospective, single-center, single-arm, pragmatic study in ET patients with an extended safety study to evaluate the efficacy and safety of the Vilim Ball—a local hand-arm vibration device that produces vibrations in the frequency range of 8–18 Hz and amplitude from 0 to 2 mm. The primary endpoint was the decrease in the power spectrum after device use. The secondary endpoints were safety outcomes. Results: In total, 17 patients with ET were included in the main study, and no patients withdrew from the main study. The tremor power spectrum (m2/s3 Hz) was lower after the device use, represented as the mean (standard deviation): 0.106 (0.221); median (Md) 0.009 with the interquartile range; IQR, 0.087 vs. 0.042 (0.078); Md = 0.009 with the IQR 0.012; Wilcoxon signed-rank test V = 123; and p = 0.027. Seven patients reported that vibrational therapy was not effective. Two patients reported an increase in tremor after using the device. In the extended safety study, we included 51 patients: 31 patients with ET and 20 with Parkinsonian tremor, where 48 patients reported an improvement in tremor symptoms and 49 in function. No serious adverse events were reported, while two patients in the Parkinsonian tremor group reported a lack of efficacy of the proposed medical device. Conclusions: the device reduces essential tremor in some patients and is safe to use in ET.


Sign in / Sign up

Export Citation Format

Share Document