Tremor in peripheral neuropathy

Smith, I.S.; Furness, Penny; Thomas, P. K.

doi:10.1007/978-1-349-06757-2_30

Cited by 13 publications

(9 citation statements)

References 9 publications

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“…Activation studies using positron emission tomography demonstrating cerebellar overactivity in patients with IgMPN and tremor seems concurrent with this possibility 29. Alternative hypotheses such as that proposed by Smith et al 8 in which tremor was felt to be in part dependent on the stretch reflex given the finding of a correlation between ulnar motor conduction velocities and thumb tremor, does not seem consistent with our findings. Bain et al 7 similarly were unable to find such a correlation.…”

Section: Discussioncontrasting

confidence: 93%

“…In only one of these was tremor present at rest in addition to action tremor. Treatment of inflammatory tremor has previously been reported to be variable (summarised by Smith8), with many treatment failures but some treatment successes using immunomodulators for treating the underlying neuropathy and rare success using other medications, such as pregabalin 31 32. Here, patients with tremor were refractory to normal oral medications used for treating tremor,33 including pregabalin.…”

Section: Discussionmentioning

confidence: 99%

“…This neuropathic tremor was first described in hereditary neuropathies as part of Roussy–Lévy syndrome3 which has since been shown to be a genetically heterogeneous entity 4 5. In inflammatory neuropathies, tremor is found in up to 80% of patients with IgM paraproteinaemic neuropathy (IgMPN),2 6 7 in the recovery phase of Guillain–Barré syndrome8 and is occasionally reported in patients with chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) 9. No relationship seems to exist between the development of tremor and the severity of the neuropathy, proprioceptive loss, weakness or fatigue10 11 but it may relate to disease activity 10.…”

Section: Introductionmentioning

confidence: 99%

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Tremor in inflammatory neuropathies

Saifee

Schwingenschuh

Reilly

et al. 2012

J Neurol Neurosurg Psychiatry

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Section: Discussioncontrasting

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Tremor in inflammatory neuropathies

Saifee

Schwingenschuh

Reilly

et al. 2012

J Neurol Neurosurg Psychiatry

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“…9 There does not seem to be a straightforward relationship between the development of tremor and conduction velocity. 10 Further, no relationship seems to exist between tremor and the severity of neuropathy as assessed by proprioceptive loss, weakness, or fatigue. 11,12 However, we have shown that although conduction velocity does not predict the presence of tremor, it is correlated with its severity for those in whom tremor is present.…”

Section: Discussionmentioning

confidence: 99%

Cerebellar learning distinguishes inflammatory neuropathy with and without tremor

et al. 2013

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Objectives: This study aims to investigate if patients with inflammatory neuropathies and tremor have evidence of dysfunction in the cerebellum and interactions in sensorimotor cortex compared to nontremulous patients and healthy controls.Methods: A prospective data collection study investigating patients with inflammatory neuropathy and tremor, patients with inflammatory neuropathy without tremor, and healthy controls on a test of cerebellar associative learning (eyeblink classical conditioning), a test of sensorimotor integration (short afferent inhibition), and a test of associative plasticity (paired associative stimulation). We also recorded tremor in the arms using accelerometry and surface EMG. Results:We found impaired responses to eyeblink classical conditioning and paired associative stimulation in patients with neuropathy and tremor compared with neuropathy patients without tremor and healthy controls. Short afferent inhibition was normal in all groups.Conclusions: Our data strongly suggest impairment of cerebellar function is linked to the production of tremor in patients with inflammatory neuropathy. Neurology â 2013;80:1867-1873 GLOSSARY ADM 5 abductor digiti minimi; ANOVA 5 analysis of variance; APB 5 abductor pollicis brevis; CIDP 5 chronic inflammatory demyelinating polyradiculoneuropathy; CR 5 conditioned blink responses; EBCC 5 eyeblink classical conditioning; FDI 5 first dorsal interossei; IgMPN 5 immunoglobulin M paraproteinaemic neuropathy; MEP 5 motor evoked potential; MMNCB 5 multifocal motor neuropathy with conduction block; MRC 5 Medical Research Council; ONLS 5 Overall Neuropathy Limitation Scale; PAS 5 paired associative stimulation; PF 5 peak tremor frequency; SAI 5 short afferent inhibition; TMS 5 transcranial magnetic stimulation; TP 5 total power of the spectra between 1 and 30 Hz used as surrogate measure of tremor amplitude; US 5 unconditioned stimulus; WE 5 wrist extensor muscles.Inflammatory mediated neuropathies are common and potentially treatable.1 Tremor occurs with immunoglobulin M paraproteinaemic neuropathy (IgMPN) 2-4 and less commonly in other inflammatory neuropathies.5 It has been suggested that temporally distorted peripheral inputs reach a normally functioning central processor, such as the cerebellum, which is misled into producing a delayed second agonist burst and tremor. [6][7][8] The involvement of the cerebellum in neuropathic tremor is supported by functional imaging abnormalities.9 There does not seem to be a straightforward relationship between the development of tremor and conduction velocity.10 Further, no relationship seems to exist between tremor and the severity of neuropathy as assessed by proprioceptive loss, weakness, or fatigue.11,12 However, we have shown that although conduction velocity does not predict the presence of tremor, it is correlated with its severity for those in whom tremor is present. 5 This indicates a second mechanism may be necessary to produce tremor. Here we set out to explore aspects of CNS physiology in tremulous ...

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“…11,12 A peripheral origin receives support from observations of distal neuropathies associated with a tremor similar to ET. 1,26 Attempts at resetting tremor by peripheral stimuli have nevertheless produced discordant results. …”

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confidence: 95%