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Essential Tremor

Bridget L Hopewell, Cristen Paige, David O Francis
Vocal tremor is a neurologic disorder with myriad etiologies (eg, Parkinson disease, medications, or essential tremor). Vocal tremor can limit intelligibility and social interaction and can result in isolation in nonprofessional voice users. In a professional singer whose entire career is based on voice quality, onset of a vocal tremor is devastating. We report a case of sudden-onset vocal tremor that impeded a young professional singer's ability to perform and record her album. The etiology was determined to be a medication side effect of lamotrigine; a reaction that has not been previously reported...
May 16, 2018: Journal of Voice: Official Journal of the Voice Foundation
Philip Smith, Ronald Arias, Shilpa Sonti, Zagaa Odgerel, Ismael Santa-Maria, Brian D McCabe, Krasimira Tsaneva-Atanasova, Elan D Louis, James J L Hodge, Lorraine N Clark
Essential Tremor (ET) is one of the most common neurological diseases, with an estimated 7 million affected individuals in the US; the pathophysiology of the disorder is poorly understood. Recently, we identified a mutation (KCNS2 (Kv9.2), c.1137 T > A, p.(D379E) in an electrically silent voltage-gated K+ channel α-subunit, Kv9.2, in a family with ET, that modulates the activity of Kv2 channels. We have produced transgenic Drosophila lines that express either the human wild type Kv9.2 (hKv9.2) or the ET causing mutant Kv9...
May 16, 2018: Scientific Reports
Alec Hughes, Yuexi Huang, Michael L Schwartz, Kullervo Hynynen
PURPOSE: To analyze clinical data indicating a reduction in the induced energy-temperature efficiency relationship during transcranial focused ultrasound (FUS) essential tremor (ET) thalamotomy treatments at higher acoustic powers, establish its relationship with the spatial distribution of the focal temperature elevation, and explore its cause. METHODS: A retrospective observational study of patients (N = 19) treated between July 2015-August 2016 for Essential Tremor (ET) by FUS thalamotomy was performed...
May 14, 2018: Medical Physics
Hongmei Cao, Rong Wang, Xue Luo, Xianjun Li, Mark Hallett, Johanna Thompson-Westra, Jian Yang, Qiumin Qu, Xiaobo Yang
BACKGROUND The aim of this study was to compare the morphological changes in cerebral and cerebellar gray matter in patients with essential tremor under 60-years-of-age, with age-matched and gender-matched normal healthy volunteer control subjects, using functional magnetic resonance imaging (fMRI) and voxel-based morphometry (VBM) analysis. MATERIAL AND METHODS A retrospective, controlled, comparative clinical study included 17 patients with essential tremor, <60 years-of-age, and 17 age-matched and gender-matched healthy volunteer control subjects, recruited between June 2010-July 2012...
May 13, 2018: Medical Science Monitor: International Medical Journal of Experimental and Clinical Research
Gabriele Mandarelli, Germana Moretti, Massimo Pasquini, Giuseppe Nicolò, Stefano Ferracuti
Deep brain stimulation (DBS) has proved useful for several movement disorders (Parkinson&rsquo;s disease, essential tremor, dystonia), in which first and/or second line pharmacological treatments were inefficacious. Initial evidence of DBS efficacy exists for refractory obsessive-compulsive disorder, treatment-resistant major depressive disorder, and impulse control disorders. Ethical concerns have been raised about the use of an invasive surgical approach involving the central nervous system in patients with possible impairment in cognitive functioning and decision-making capacity...
May 11, 2018: Brain Sciences
Freek Nieuwhof, Pattamon Panyakaew, Bart P van de Warrenburg, Cecile Gallea, Rick C Helmich
PURPOSE OF REVIEW: We focus on new insights in the pathophysiology of Parkinson's disease tremor, essential tremor, tremor in dystonia, and orthostatic tremor. RECENT FINDINGS: Neuroimaging findings suggest that Parkinson's disease resting tremor is associated with dopaminergic dysfunction, serotonergic dysfunction, or both. Not all tremors in Parkinson's disease have the same pathophysiology: postural tremor in Parkinson's disease can be subdivided into pure postural tremor, which involves nondopaminergic mechanisms, and re-emergent tremor, which has a dopaminergic basis...
May 9, 2018: Current Opinion in Neurology
M Alonso-Juarez, J F Baizabal-Carvallo
BACKGROUND: Tremor frequently occurs in patients taking valproate and may resemble that observed in patients with essential tremor (ET). We aimed to compare the distribution, severity, and functional impact of both types of tremor. METHODS: Among 118 consecutive individuals taking valproate, we identified 28 patients with valproate-induced tremor severe enough to require pharmacological treatment; through evaluations using the Clinical Rating Scale for Tremor (CRST), they were compared with 29 consecutive patients with ET...
May 10, 2018: Acta Neurologica Scandinavica
Dietrich Haubenberger, Mark Hallett
New England Journal of Medicine, Volume 378, Issue 19, Page 1802-1810, May 2018.
May 10, 2018: New England Journal of Medicine
Alexia-Sabine Moldovan, Christian Johannes Hartmann, Carlos Trenado, Nicola Meumertzheim, Philipp Jörg Slotty, Jan Vesper, Alfons Schnitzler, Stefan Jun Groiss
BACKGROUND: Shorter pulse widths than conventional pulse width settings may lead to reduction of side effects and therefore be a valuable therapeutic option for deep brain stimulation (DBS) in patients with essential tremor (ET). OBJECTIVE: To compare the DBS effect of shorter pulse width at 40 μs (DBS-40 μs) to conventional pulse width at 60 μs (DBS-60 μs) on the therapeutic window in ET patients. METHODS: For this prospective, randomized, double-blind, crossover study 9 ET patients with chronic DBS of the ventral intermediate nucleus (VIM)/posterior subthalamic area (PSA) were recruited...
April 26, 2018: Brain Stimulation
Chandrabhaga Miskin, Karen S Carvalho
Tremor is a fairly common movement disorder presenting to an outpatient pediatric neurology practice. Tremors can be primary or secondary to underlying neurologic or systemic diseases. When assessing a child with tremor, it is paramount to evaluate the phenomenology of the tremor, determine the presence or absence of other neurologic signs and symptoms, and the possible modifying influence of medications. Proper classification is essential for specific diagnosis and prompt adequate management. Treatment considerations should take into account objective assessment of tremor severity and the degree of disability or impairment experienced by the child...
April 2018: Seminars in Pediatric Neurology
Kalen J Petersen, Jacqueline A Reid, Srijata Chakravorti, Meher R Juttukonda, Giulia Franco, Paula Trujillo, Adam J Stark, Benoit M Dawant, Manus J Donahue, Daniel O Claassen
The dentato-rubro-thalamic tract (DRTT) regulates motor control, connecting the cerebellum to the thalamus. This tract is modulated by deep-brain stimulation in the surgical treatment of medically refractory tremor, especially in essential tremor, where high-frequency stimulation of the thalamus can improve symptoms. The DRTT is classically described as a decussating pathway, ascending to the contralateral thalamus. However, the existence of a nondecussating (i.e. ipsilateral) DRTT in humans was recently demonstrated, and these tracts are arranged in distinct regions of the superior cerebellar peduncle...
May 4, 2018: NeuroImage
Jean-Francois Daneault
Essential tremor (ET) is the most common movement disorder. Individuals exhibit postural and kinetic tremor that worsens over time and patients may also exhibit other motor and non-motor symptoms. While millions of people are affected by this disorder worldwide, several barriers impede an optimal clinical management of symptoms. In this paper, we discuss the impact of ET on patients and review major issues to the optimal management of ET; from the side-effects and limited efficacy of current medical treatments to the limited number of people who seek treatment for their tremor...
2018: Frontiers in Neurology
Muthuraman Muthuraman, Jan Raethjen, Nabin Koirala, Abdul Rauf Anwar, Kidist G Mideksa, Rodger Elble, Sergiu Groppa, Günter Deuschl
Cerebello-thalamo-cortical loops play a major role in the emergence of pathological tremors and voluntary rhythmic movements. It is unclear whether these loops differ anatomically or functionally in different types of tremor. We compared age- and sex-matched groups of patients with Parkinson's disease or essential tremor and healthy controls (n = 34 per group). High-density 256-channel EEG and multi-channel EMG from extensor and flexor muscles of both wrists were recorded simultaneously while extending the hands against gravity with the forearms supported...
April 26, 2018: Brain: a Journal of Neurology
Judit Horvath, Emmanuelle Ranza
Movement disorders of monogenic origin are rare. In case of a specific phenotype, classical targeted sequencing of the gene can be used. When the clinical picture is not well defined, or when there is genetic heterogeneity or a large differential diagnosis, high-throughput sequencing is a useful tool for the analysis of numerous genes simultaneously. To discuss which approach is optimal, a multidisciplinary consultation by a movement disorders specialist and a geneticist is recommended. For some genetic movement disorders there is specific treatment available...
April 25, 2018: Revue Médicale Suisse
Paul S Fishman, W Jeffrey Elias, Pejman Ghanouni, Ryder Gwinn, Nir Lipsman, Michael Schwartz, Jin W Chang, Takaomi Taira, Vibhor Krishna, Ali Rezai, Kazumichi Yamada, Keiji Igase, Rees Cosgrove, Haruhiko Kashima, Michael G Kaplitt, Travis S Tierney, Howard M Eisenberg
BACKGROUND: Magnetic resonance imaging-guided focused ultrasound thalamotomy is approved by the U.S. Food and Drug Administration for treatment of essential tremor. Although this incisionless technology creates an ablative lesion, it potentially avoids serious complications of open stereotactic surgery. OBJECTIVE: To determine the safety profile of magnetic resonance imaging-guided focused ultrasound unilateral thalamotomy for essential tremor, including frequency, and severity of adverse events, including serious adverse events...
April 27, 2018: Movement Disorders: Official Journal of the Movement Disorder Society
Hongmei Cao, Johanna Thompson-Westra, Mark Hallett, Dietrich Haubenberger
OBJECTIVE: To investigate the effect of octanoic acid (OA) on the peripheral component of tremor, as well as OA's differential effects on the central and peripheral tremor component in essential tremor (ET) patients. METHODS: We analyzed postural tremor accelerometry data from a double-blind placebo-controlled cross-over study evaluating the effect of 4 mg/kg OA in ET. The weighted condition was used to identify tremor power for both the central and peripheral tremor components...
April 3, 2018: Clinical Neurophysiology: Official Journal of the International Federation of Clinical Neurophysiology
Sangeetha Yoganathan, Mugil Varman, Samuel Philip Oommen, Maya Thomas
Nutritional deficiencies related neurological manifestations are not uncommon in infants and children. Here, we describe an infant with Vitamin B12 deficiency due to depleted maternal Vitamin B12 status presenting with progressive encephalopathy and extrapyramidal signs. Diagnosis of infantile tremor syndrome was established in our patient based on the clinical and biochemical parameters. Magnetic resonance imaging had shown frontotemporal atrophy with widened Sylvian fissures and prominent cerebrospinal fluid spaces...
October 2017: Journal of Pediatric Neurosciences
Robert D Shura, Robin A Hurley, Katherine H Taber
No abstract text is available yet for this article.
2018: Journal of Neuropsychiatry and Clinical Neurosciences
Derek B Archer, Stephen A Coombes, Winston T Chu, Jae Woo Chung, Roxana G Burciu, Michael S Okun, Aparna Wagle Shukla, David E Vaillancourt
No abstract text is available yet for this article.
April 12, 2018: Brain: a Journal of Neurology
Constantin Tuleasca, Jean Régis, Elena Najdenovska, Tatiana Witjas, Nadine Girard, Jean-Philippe Thiran, Meritxell Bach Cuadra, Marc Levivier, Dimitri Van De Ville
No abstract text is available yet for this article.
April 12, 2018: Brain: a Journal of Neurology
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