Clinical characteristics of essential tremor: Data from a community‐based study

Louis, Elan D.; Ford, Blair; Wendt, Kristin J.; Cameron, Gabriella

doi:10.1002/mds.870130508

Cited by 82 publications

(81 citation statements)

References 30 publications

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“…Most of our cases were previously undiagnosed with ET and few were taking medication for their tremor, as has been reported in other population-based samples [11,12] . The use of such mild cases may have made it more difficult to detect medical comorbidities such as hearing impairment, thereby biasing our estimate of the association between hearing impairment and ET towards the null hypothesis.…”

Section: Discussionsupporting

confidence: 55%

Reported Hearing Impairment in Essential Tremor: A Population-Based Case-Control Study

2007

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In a population-based sample, we determined whether a larger proportion of essential tremor (ET) cases reported hearing impairment compared with controls. Ninety-six (38.7%) of 248 ET cases versus 1,371 (29.4%) of 4,669 controls (p = 0.002) reported hearing impairment. In a logistic regression analysis adjusted for age, gender, educational level, depressive symptoms, and dementia, participants who reported hearing impairment were 30% more likely to suffer from ET than were controls (odds ratio 1.3; 95% confidence interval 1.01–1.7; p = 0.04). ET seemed to be associated with reported hearing impairment. The basis for this finding, which has been noted in several studies, deserves further exploration.

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Section: Discussionsupporting

confidence: 55%

Reported Hearing Impairment in Essential Tremor: A Population-Based Case-Control Study

2007

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“…which was asked during the tremor interview. In comparison, a group of 73 subjects with mild essential tremor, 28 (38.4%) answered yes to this question [20]. Also, these subjects almost all (196%) answered no to a series of other questions that related to functional impairment resulting from tremor ('Does your hand usually tremble when you hold a pen or write your name?'…”

Section: Discussionmentioning

confidence: 99%

Senile Tremor

Louis

Wendt

Ford³

1999

Gerontology

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Background/Setting: It is well recognized that mild tremor is common among older adults, but the prevalence and clinical characteristics of this tremor have not been studied in detail. Objectives: To examine a cohort of normal older adults to: (1) ascertain the prevalence of mild test-detectible tremor; (2) quantify the severity and functional impact of this tremor, and (3) determine whether age, gender and concomitant illness predict the severity of tremor. Participants: 76 normal older adults >55 years of age (mean age = 73.7 years). Design: Healthy older adults were identified in a community-based case-control study of essential tremor in Washington Heights-Inwood, New York. All subjects underwent a medical interview and a videotaped neurological examination. The examination included six tests: arm extension, pouring water, drinking water, using a spoon, finger-to-nose movements, and drawing spirals with each arm. Two neurologists rated the severity of tremor using a 0 to +3 clinical rating scale and a total tremor score (TTS) was calculated (range = 0–36). Forward stepwise linear regression was used to determine the association between TTS and other variables. Results: Virtually all (75 or 98.7%) showed signs of tremor (TTS > 0.5). The mean TTS = 6.3 (range = 0–14.5), corresponding to a tremor that was either mild or intermittent. Twenty-eight of 76 (36.8%) received tremor ratings of +2 (clearly oscillatory tremor of moderate amplitude and usually present) during at least one of the six tests; a tremor rating of +2 was 2.1 times more likely to occur in the nondominant than in the dominant hand. Those who were aged 57–74 years had a lower mean TTS (5.8) than those aged 75–93 (6.8), but this was not significant. Only 2 patients (2.6%) answered ‘yes’ to the question ‘do you have uncontrollable shaking in your hands?’ None was taking medication to treat tremor. Gender, ethnicity, concomitant illness (diabetes, arthritis, heart disease), and medications were not associated with a higher TTS. Conclusion: Mild but test-detectible tremor was present in almost all normal older adults, and in one-third this tremor attained a moderate amplitude during at least one activity. Characterization of this tremor would be of value to practitioners who care for older adults.

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“…4 A finding that was confirmed recently in a communitybased study. 5 The majority of candidates for functional neurosurgery belong to the ET group who have severe intention tremors. It is important to note that these patients also suffer from a disorder of tandem gait.…”

Section: Diagnosismentioning

confidence: 99%

“…(4) What are the chances for medical treatment in a particular patient? (5) What is known about the outcome of surgery in a specific condition? (6) What are the individual risks of complications?…”

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confidence: 99%

Deep brain stimulation for trauma: Patient selection and evaluation

Deuschl

Bain

2002

Mov Disord.

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The selection of patients with movement disorders for deep brain stimulation is becoming a common neurological and neurosurgical task. Deep brain stimulation is suitable for different forms of tremor, which can often not be treated with medication. This suitability applies for essential tremor, monosymptomatic tremor at rest, cerebellar or multiple sclerosis tremor, Holmes' tremor, primary writing tremor or tremor in neuropathies. The appropriate selection of patients is critical for the outcome of surgical relief of tremors. Considering the risks of any stereotactic intervention, the following must apply: (1) motor symptoms lead to a relevant disability in activities of daily living, despite optimal medical treatment; (2) biological age of the patient; (3) neurosurgical contraindications; (4) the patient is neither demented nor severely depressed. If these conditions are fulfilled, the individual chances of improvement of the target symptoms need to be checked, based on the following guidelines: (1) the kind of tremor, (2) the natural course of the tremor, (3) the chances for medical treatment in a particular patient, (4) the outcome of surgery in a specific condition, (5) the individual risks for a patient to suffer from complications. The outcome of surgery for tremor depends on the clinical type and distribution. Distal limb tremors are easier to treat than proximal limb tremors. Intention tremor is more difficult to treat than rest or postural tremor. The indication for surgical treatment depends on the analysis of the individual risk-benefit ratio, which also has to take into account the patients' social, professional, and familial background. The patient needs to be well informed about his individual risk-benefit ratio and of alternative treatments, before undergoing stereotactic surgery.

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Clinical characteristics of essential tremor: Data from a community‐based study

Cited by 82 publications

References 30 publications

Reported Hearing Impairment in Essential Tremor: A Population-Based Case-Control Study

Reported Hearing Impairment in Essential Tremor: A Population-Based Case-Control Study

Senile Tremor

Deep brain stimulation for trauma: Patient selection and evaluation

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