Tremor in primary adult-onset dystonia: prevalence and associated clinical features

Abstract

Tremor is a relatively common feature occurring in about 17% of patients with primary late-onset dystonia. The association between tremor and dystonia spread suggests that this form of tremor may be a dystonic manifestation. Similarities in phenotypic features of DT and TAWD predominated over differences, suggesting that the two forms of tremor may be manifestations of the same disease. Differences in gender and body distribution of tremor between patients with dystonia and tremor and those of patients with essential tremor also suggest that tremor in dystonia and essential tremor are different entities.

Rest and other types of tremor in adult-onset primary dystonia

“…Such a huge discrepancy between studies might be due to several factors, including small patient samples, with focus on only one type of focal dystonia, and use of medical chart reviews rather than clinical examination to detect tremor. Intriguingly, the largest study which specifically addressed this question in 429 AOPD patients, found postural or postural/kinetic tremor in 16.7% of the cases, while none had rest tremor 2. We do not believe that methodological issues can explain such discrepancy: similarly to Defazio et al , we have, in fact, clinically assessed consecutive AOPD patients, with the specific aim to look for tremor and its characteristics.…”

“…Previous studies have reported tremor frequencies ranging from 7% to 70% in AOPD 2 8–10. Such a huge discrepancy between studies might be due to several factors, including small patient samples, with focus on only one type of focal dystonia, and use of medical chart reviews rather than clinical examination to detect tremor.…”

“…It is mostly found in Parkinson's disease (PD) but can be less frequently seen in other conditions, such as essential tremor (ET) and dystonia 1. Although there is a consensus stating that tremor and dystonia can be associated,1 little is known regarding tremor prevalence and phenomenology in patients with adult onset primary dystonia (AOPD) and only one study has focused on its characteristics in a large cohort of patients with AOPD so far 2. The authors found that tremor is a relatively common feature, being postural or postural/kinetic in nature and occurring in about 17% of patients with AOPD.…”

Parkinson's disease: chameleons and mimics

“…Dystonic tremor may be a major cause of disease in patients with SWEDDS. In patients with dystonic and essential tremor, dopamine-transporter scan ( 123 I-FP-CIT SPECT scan (DaTscan)) is normal, indicating that there is no presynaptic dopaminergic deficit 39 40 45 46…”

Cranial dystonia

“…Такой широкий разброс данных можно объяснить генетической гетеро-генностью и влиянием условий окру-жающей среды [7,8]. Пациенты с бле-фароспазмом, например, чаще встре-чаются в южных регионах с высоким уровнем инсоляции [7,[9][10][11][12][13][14][15]. Возраст является независимым фактором риска развития краниальной дистонии, средний возраст начала за-болевания -50-60 лет [16][17][18] [17,18,20, 21].…”