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Tremor and Other Hyperkinetic Movements

Pichet Termsarasab, Yuvadee Pitakpatapee, Steven J Frucht, Prachaya Srivanitchapoom
Background: Myoclonus and tremor are common movement disorder phenomenologies in steroid-responsive encephalopathy associated with autoimmune thyroiditis (SREAT). Pure ataxia without encephalopathy has rarely been reported. Case report: We report 21- and 40-year-old females who presented with subacute pure ataxia without encephalopathy. After immunotherapies, both exhibited initial improvement of ataxia, and subsequently remained in plateau phase. Discussion: This treatable disorder should be added to the differential diagnoses of progressive cerebellar ataxia, and anti-thyroid peroxidase and anti-thyroglobulin should be considered as part of the workup...
2018: Tremor and Other Hyperkinetic Movements
Norma L Alvarado-Franco, Catalina Gonzalez-Marques, Leticia A Olguín-Ramírez, Alejandro Garza-Alpirez, Giovana Femat-Roldan, Daniel Martinez-Ramirez
Background: Primary Sjögren syndrome (pSS) is an autoimmune disorder characterized by exocrine gland and extraglandular symptoms. We present a case report of pSS with an initial presentation of athetoid movements. Case Report: A 74-year-old female presented with a 2-month history of slow undulating movements in her trunk and thighs that eventually spread to her neck and lower extremities. She also reported dry eyes, dry mouth, as well as pain in her shoulders and thighs...
2018: Tremor and Other Hyperkinetic Movements
Anelyssa D'Abreu, Joseph H Friedman
Background: Although tardive dyskinesia (TD) is most commonly defined as a movement disorder caused by chronic exposure to dopamine-receptor-blocking drugs (DRBDs), it has also been thought to result from exposure to some non-DRBDs. Methods: We critiqued many reviews making the association between non-DRBDs and a TD-like syndrome and almost all case reports. We checked whether cases met criteria for the diagnosis of TD-like syndrome and whether DRBDs had been excluded...
2018: Tremor and Other Hyperkinetic Movements
Ashley K Yearwood, Shruthi Rethi, Karla P Figueroa, Ruth H Walker, Andrew K Sobering
Background: Access to medical care in many regions is limited by socioeconomic status, at both the individual and the community level. This report describes the diagnostic process of a family residing on an underserved Caribbean island where routine neurological care is typically addressed by general practitioners, and genetic diagnosis is not available through regular medical channels. The diagnosis and management of neurodegenerative disorders is especially challenging in this setting...
2018: Tremor and Other Hyperkinetic Movements
Virgilio Gerald H Evidente, Zachary J Baker, Maris H Evidente, Robin Garrett, Margaret Lambert, Francisco A Ponce
Background: Orthostatic tremor (OT) is a hyperkinetic movement disorder characterized by rapid tremor in the lower extremities or trunk upon standing. Case Report: We report two patients presenting with OT, whose symptoms improved markedly following asleep bilateral thalamic deep brain stimulation (DBS) surgery. Discussion: Medically refractory OT can respond favorably to asleep bilateral DBS surgery similar to awake surgery, and may have the advantages of less psychological trauma to the patient, shorter procedure times, and less exposure to anesthesia...
2018: Tremor and Other Hyperkinetic Movements
Natalia González Rojas, Martin Cesarini, José Luis Etcheverry, Gustavo Da Prat, Tomás Viera Aramburu, Emilia Mabel Gatto
Background: Holmes tremor is a rare symptomatic movement disorder, characterized by a combination of resting, postural, and intention tremor. It is usually caused by lesions in the brainstem, thalamus, and cerebellum. Despite pharmacological advances, its treatment remains a challenge; many medications have been used with various degrees of effectiveness. Stereotactic thalamotomy and deep brain stimulation in the ventralis intermedius nucleus have been effective surgical procedures in cases refractory to medical treatment...
2018: Tremor and Other Hyperkinetic Movements
Adrian Handforth, Pournima A Kadam, Hovsep P Kosoyan, Pirooz Eslami
Background: Metabolic imaging has revealed excessive cerebellar activity in essential tremor patients. Golgi cells control cerebellar activity by releasing gamma-aminobutyric acid (GABA) onto synaptic and extrasynaptic receptors on cerebellar granule cells. We postulated that the extrasynaptic GABAA receptor-specific agonist THIP (gaboxadol; 4,5,6,7-tetrahydroisoxazolo[5,4-c]pyridin-3-ol) would suppress tremor in the harmaline model of essential tremor and, since cerebellar extrasynaptic receptors contain α 6 and δ subunits, would fail to do so in mice lacking either subunit...
2018: Tremor and Other Hyperkinetic Movements
Jung E Park
Background: Functional movement disorders are recognized as a "crisis" in neurology. We aimed to determine the rate of incidence of functional movement disorder patients at a university outpatient neurology clinic in South Korea, and highlight the clinical and phenomenological characteristics. Methods: Patients who were assessed by a movement disorders neurologist at a university hospital between March 2016 and May 2017 were screened for functional movement disorders...
2018: Tremor and Other Hyperkinetic Movements
(no author information available yet)
[This corrects the article DOI: 10.7916/D89S20H7.].
2018: Tremor and Other Hyperkinetic Movements
Josef Finsterer, Fulvio A Scorza, Ana C Fiorini, Carla A Scorza, Antonio Carlos Almeida
In Response To: Giron C, Roze E, Degos, B, Méneret A, Jardel C, Lannuzel A, et al. Adult-onset generalized dystonia as the main manifestation of MEGDEL syndrome. Tremor Other Hyperkinet Mov. 2018; 8. doi: 10.7916/D8VM5VBQ.
2018: Tremor and Other Hyperkinetic Movements
Gholamali Shahidi, Mohammad Rohani, Renato Puppi Munhoz, Fahimeh H Akhoundi
Background: Akathisia is an inner urge to move a body area with an objective motor component of restlessness. Tardive akathisia (TA) is usually bilateral with a predominant lower-body presentation. We report two patients with an asymmetrical predominantly upper-body involvement. Case Report: Two young men with history of psychiatric problems and neuroleptic use revealed atypical TA, characterized by asymmetrical and predominantly upper-body involvement. Their main manifestations were rubbing the face, mostly with one hand, accompanied by an inner sensation of restlessness...
2018: Tremor and Other Hyperkinetic Movements
Femke Dijkstra, Mineke Viaene, Inge Beijer, Harald de Cauwer
Background: Sleep-related rhythmic movement disorder occurs frequently in childhood with a minority of patients having persistent symptoms in adolescence. Phenomenology Shown: We describe a 14-year-old female showing a typical example of head banging at onset of sleep. Educational Value: Sleep-related rhythmic movement disorder usually has a benign and self-limiting nature and medication might only be warranted in cases of severe sleep disruption or frequent injuries...
2018: Tremor and Other Hyperkinetic Movements
Deepak K Gupta, Victor A Blanco-Palmero, Wendy K Chung, Sheng-Han Kuo
Background: Adult-onset Niemann-Pick Type C is a rare neurogenetic lysosomal disorder, whose diagnosis is often delayed and missed because of its heterogeneous clinical presentations and rarity as well as the lack of awareness of characteristic eye findings among neurologists. Phenomenology Shown: Impaired smooth pursuits, saccades, and optokinetic nystagmus in the vertical direction, with relatively normal eye movements in the horizontal direction, and ataxia features on finger chase testing, tandem walking, and gait ataxia...
2018: Tremor and Other Hyperkinetic Movements
Amar Patel, Wissam Deeb, Michael S Okun
Clinical Vignette: A 64-year-old female with essential tremor (ET) presents for evaluation of deep brain stimulation (DBS) candidacy. Examination revealed subtle dystonic features as well as a disabling postural-action tremor. Clinical Dilemma: Can dystonia occur in the setting of the diagnosis of ET and can its presence alter DBS target selection? Clinical Solution: Unilateral DBS implantation of the ventralis intermedius (Vim) led to improvement in both tremor and dystonic posturing...
2018: Tremor and Other Hyperkinetic Movements
Aneesh Karir, Michael Geraghty, Michael Vassilyadi, Asif Doja
Background: Hemifacial spasms are involuntary contractions of the muscles of one side of the face. Case Report: Here, we report a 5-year-old female patient with a significant past medical history, including mucopolysaccharidosis type VI, who also presented with hemifacial spasms. Further investigations showed narrowing of skull foramina and hydrocephalus, but no compression of the facial nerve. Carbamazepine was given to the patient, which caused cessation of the spasms...
2018: Tremor and Other Hyperkinetic Movements
Malco Rossi, Martin Cesarini, Emilia M Gatto, Angel Cammarota, Marcelo Merello
Background: Cerebrotendinous xanthomatosis is a rare autosomal recessive neurometabolic disorder characterized by chronic diarrhea, tendon xanthomas, juvenile cataracts, and neurological symptoms. Case Report: An adult patient with cerebrotendinous xanthomatosis exhibited ataxia and palatal tremor in the absence of tendon xanthomas and cataracts. Discussion: The importance of this case resides on the fact that cerebrotendinous xanthomatosis should be considered as a possible etiology of the syndrome of progressive ataxia with palatal tremor, even in the absence of tendon xanthomas and cataracts...
2018: Tremor and Other Hyperkinetic Movements
Adrian Handforth, Gail A Parker
Background: Increased depression, hearing loss, dementia, alcoholism, and mortality in essential tremor patients remain unexplained. We investigated whether conditions associated with tremor are linked to chronic stress. Methods: The FY2013 Veterans Affairs database was queried for 38 selected dual diagnosis combinations in 5,854,223 veterans aged 21-95 years. Results: Post-traumatic stress disorder, anxiety, and depression were the most common psychiatric diagnoses in tremor patients, with the odds ratio exceeding 2 in all 15-year cohorts...
2018: Tremor and Other Hyperkinetic Movements
Zain Guduru, John Morgan, Kapil Sethi
Background: We report a patient who developed lower facial muscle spasm at rest and bilateral facial synkinesis several months after treatment of Guillain-Barré syndrome (GBS); this finding, to our knowledge, is hitherto unreported. Phenomenology Shown: Bilateral synkinesis, facial muscles spasm at rest, bilateral postparalytic facial syndrome. Educational Value: Aberrant regeneration of nerve fibers post GBS, resulting in facial muscles spasm at rest, bilateral synkinesis...
2018: Tremor and Other Hyperkinetic Movements
Camille Giron, Emmanuel Roze, Bertrand Degos, Aurélie Méneret, Claude Jardel, Annie Lannuzel, Fanny Mochel
Background: MEGDEL syndrome (3-MethylGlutaconic aciduria, Deafness, Encephalopathy, Leigh-like syndrome) is a severe neurometabolic disease with infantile onset. Phenomenology Shown: Progressive and marked dystonia over a 6-year period in an adult male with MEGDEL syndrome. Educational Value: Generalized dystonia may be the main manifestation of a milder form of MEGDEL syndrome, which begins during adulthood.
2018: Tremor and Other Hyperkinetic Movements
María Ruiz-Julián, Jorge Luís Orozco, Alexandre Gironell
Background: Primary orthostatic tremor (POT) is an infrequent disorder whose physiopathology is unknown. Current medication is largely ineffective or only offers mild benefits. Case Report: A 75-year-old female with refractory POT treated with 4 mg/day of perampanel achieved complete symptom resolution. Owing to adverse effects, the patient reduced intake to 2 mg/day, but even at this lower dose the benefit was maintained. Discussion: We report the complete resolution of POT symptoms using low doses of perampanel, an antiepileptic drug that blocks glutamate-mediated post-synaptic excitation...
2018: Tremor and Other Hyperkinetic Movements
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