Electrophysiological testing aids the diagnosis of tremor and myoclonus in clinically challenging patients

Task-Specific Drinking Tremor

“…Our case also demonstrates that significant clinical alleviation can be obtained with EMG and tremor burst analysis. Our findings are in accordance with other reports that found EMG recordings to be useful in evaluating oromandibular dystonia (e.g., 6 ), in assessing tremor and in monitoring the treatment effect. 7 Jaw tremor can be a symptom in various disorders.…”

“…Our findings are in accordance with other reports that found EMG recordings to be useful in evaluating oromandibular dystonia (e.g. [ 6 ], ), in assessing tremor and in monitoring the treatment effect [ 7 ].…”

Bedside clinical assessment of patients with common upper limb tremor and algorithmic approach

“…The first step in neurophysiological testing is to distinguish tremor from tremor mimics, particularly myoclonus [ 9 ]. Regular EMG bursts >100 ms in duration with a predominantly alternating EMG pattern between the antagonist pairs are consistent with tremor, while irregular short EMG bursts (<50 ms) standing out from the background with synchronous EMG pattern are suggestive of myoclonus [ 12 , 14 ]. Irregular, asynchronous, and very short EMG bursts (11–40 ms) would be considered as polyminimyoclonus [ 97 ].…”

“…Myoclonus is usually manifested as a sudden, irregular, and shocklike jerky movement. However, high-frequency (8)(9)(10)(11)(12)(13)(14)(15)(16)(17)(18) repetitive myoclonus, called cortical tremor, can be a difficult diagnosis [10,[12][13][14]. In addition, some tremors are not totally rhythmic and may present as an irregular movement such as dystonic tremor (DT) (tremor that appears in the dystonic part), Holmes tremor (HT), and tremor with different amplitudes in various situations, which could clinically overlap with myoclonus [7,[15][16][17].…”

Subband Independent Component Analysis for Coherence Enhancement

“…Coherence between EEG and EMG has enhanced our understanding of normal sensorimotor control [5], [6] and of the pathophysiology of movement disorders, such as tremor [6], [7], [8], myoclonus [8], [9], [10], Parkinson's disease [11], [12], [13], and dystonia [14], [15], [16]. Clinical application of EEG-EMG coherence includes distinguishing between different types of movement disorder, such as tremor versus myoclonus [8], or between different tremor types [8], [17]. However, the full potential of EEG-EMG coherence in the clinical assessment of motor disorders is yet to be fully realised, partly due to its considerable variability between individuals.…”