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TITLE: Essential tremor: clinical characteristics.
AUTHORS: Jankovic J
AUTHOR AFFILIATION: Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA.
SOURCE: Neurology 2000;54(11 Suppl 4):S21-5
CITATION IDS: PMID: 10854348 UI: 20312903
ABSTRACT: Essential tremor (ET) is the most common movement disorder. However, only a small percentage of people affected by this genetically transmitted neurologic disorder seek medical attention. Lack of consensus on the diagnostic criteria for ET is an impediment to accurate diagnosis and leads to difficulty in accessing accurate prevalence data. Although a positive family history, alcohol sensitivity, and propranolol responsiveness are characteristic of ET, these factors should not be considered necessary for the diagnosis of ET. ET can produce substantial physical and psychosocial disabilities. The occasional coexistence of ET and Parkinson's disease (PD) in the same individual may present a diagnostic challenge.

2000/07
2000/08 11:00


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TITLE: Epidemiology and genetics of essential tremor.
AUTHORS: Findley LJ
AUTHOR AFFILIATION: Essex Neurosciences Unit, Oldchurch Hospital, Essex RM7 0BE, United Kingdom.
SOURCE: Neurology 2000;54(11 Suppl 4):S8-S13
CITATION IDS: PMID: 10854346 UI: 20312901
ABSTRACT: Essential tremor (ET) is probably the most common movement disorder and is a common cause of social, physical, and psychological handicaps. Its etiology and pathogenesis are unknown. Phenomenologically, ET overlaps and is associated with other disorders of movement, such as parkinsonism and dystonia. There is large variation in the stated prevalence of ET as well as limited availability of epidemiologic studies. Prevalence variations reflect differences in the definition of ET and the methodologies of investigation. The familial and sporadic forms of ET are generally assumed to be similar. The familial form appears to have a narrow phenotype. Wide variation in the reported percentage of patients with positive family history reflects ascertainment and classification differences. Linkage of ET to two different chromosome locations has been reported.

2000/07
2000/08 11:00


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TITLE: Ethnic differences in essential tremor.
AUTHORS: Louis ED; Barnes LF; Ford B; Pullman SL; Yu Q
AUTHOR AFFILIATION: Gertrude H. Sergievsky Center, Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA. Louisel@sergievsky.cpmc.columbia.edu
SOURCE: Arch Neurol 2000 May;57(5):723-7
CITATION IDS: PMID: 10815139 UI: 20273274
ABSTRACT: BACKGROUND: Ethnic differences in the clinical characteristics (severity and distribution) of essential tumor (ET) have not been studied. The presence of these differences suggests that ET is not a homogeneous disease and that there is variability in disease expression under different circumstances. As part of a community-based study, we evaluated a multiethnic group of cases.

OBJECTIVE: To assess whether there are ethnic differences in the clinical characteristics of ET.

METHODS: Elderly residents of Washington Heights-Inwood, New York, were enrolled in a community-based health study (N = 2117). Participants underwent a medical interview and a neurological examination conducted by a neurologist, and subjects with ET were identified. These subjects with ET were then enrolled in a community-based study of ET and underwent a tremor interview, a videotaped tremor examination, and in some cases, a performance-based test of function and quantitative computerized tremor analysis. A total tremor score (range, 0-36, with 0 indicating no tremor and 36 indicating maximum tremor) was assigned to each subject based on 2 neurologists' ratings of the tremor examination.

RESULTS: Among 62 subjects with ET (white [n = 16], African American [n = 18], and Hispanic [n = 28]), there were ethnic differences in the total tremor score (F = 3.68, P = .03). In a multiple regression model adjusting for age, white subjects had a mean total tremor score that was 5.3 points lower than that of nonwhite subjects (P = .008). We divided the nonwhite group into African American and Hispanic subgroups. In a regression model adjusting for age and duration, the white group had a mean total tremor score that was 6.1 points lower than that of the Hispanic group (P = .07) and 7.2 points lower than that of the African American group (P = .05). The mean performance-based test score was 1.7 times higher in the African American group and 2.1 times higher in the Hispanic group compared with the white group (P = .38). No subjects in the African American group had head tremor, while 4 subjects in the white group (25%) and 8 subjects in the Hispanic group (29%) did have head tremor (chi2 = 6.17, P = .05).

CONCLUSIONS: There are ethnic differences in the expression of ET, suggesting that ET is not a homogeneous disorder. These differences may reflect phenotypic variability caused by genotypic differences or differences in exposure to environmental factors that influence tremor.

2000/06
2000/03 09:00


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TITLE: Validation of a portable instrument for assessing tremor severity in epidemiologic field studies.
AUTHORS: Louis ED; Yousefzadeh E; Barnes LF; Yu Q; Pullman SL; Wendt KJ
AUTHOR AFFILIATION: Department of Neurology and the Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA.
SOURCE: Mov Disord 2000 Jan;15(1):95-102
CITATION IDS: PMID: 10634247 UI: 20097713
ABSTRACT: BACKGROUND: An important part of epidemiologic and genetic studies of essential tremor (ET) is an assessment of tremor severity. Clinical rating scales are semiquantitative and computerized tremor analysis, available at tertiary medical centers, is not transportable into the field. As part of an epidemiologic study, we modified the Klove-Matthews Motor Steadiness Battery, collecting objective quantitative data on tremor severity in patients with ET and control subjects.

OBJECTIVE: To describe the modified Klove-Matthews Motor Steadiness Battery, validate this test battery against several other measures of tremor severity, demonstrate test-retest reliability, and provide standard reference values for normal control subjects and patients with ET who undergo this test battery.

METHODS: Patients with ET and control subjects, ascertained from both a clinic and a community, underwent a standardized evaluation including a demographic and medical questionnaire, tremor disability questionnaire, videotaped tremor examination, performance-based test, modified Klove-Matthews Motor Steadiness Battery (Groove-Type Steadiness Tester [GTST] and Nine-Hole Steadiness Tester [NHST]), and quantitative computerized tremor analysis. RESULTS: There were 19 patients with ET and 28 control subjects. NHST and GTST total scores were correlated significantly with the tremor disability questionnaire score (r = 0.63, p = 0.001 and r = 0.49, p = 0.016), total tremor score (tremor examination, r = 0.68, p<0.001 and r = 0.41, p = 0.005), performance-based test score (r = 0.81, p<0.001 and r = 0.65, p = 0.001), and quantitative computerized tremor analysis results (for example, spiral drawing, r = 0.62, p = 0.01 and r = 0.58, p = 0.019). Test-retest reliability was generally high (r = 0.79-0.94, p<0.001).

CONCLUSION: The modified Klove-Matthews Motor Steadiness Battery provides a reliable and valid means to collect objective quantitative data on tremor severity. Rapidity of administration and ease of transport make it a potentially useful tool in epidemiologic and genetic field studies.

2000/01
2000/14 09:00



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