Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Forty-seven railroad workers who were exposed to polychlorinated phenols, including dioxin (TCDD), during 1979 while cleaning up the chemical spillage following damage to a tank car filled with these chemicals were followed medically for the subsequent 6 years. Two committed suicide. The initial neurological complaints included a sense of fatigue and muscle aching, both of which have been reported in other individuals following dioxin exposure. On detailed neurological examination in December, 1985, 24 of 45 had dystonic writer's cramp and/or other action dystonias of the hands. None of the involved individuals had a family history of dystonia, and all 24 dated the onset of the dystonia to the first 2 to 3 years subsequent to their toxic exposure. The dystonias varied in severity but were usually mild. No other types of dystonic involvement were recognized. Thirty-five of the 45 individuals also manifested postural and terminal intention tremor which resembled benign essential tremor. None of the involved individuals had a family history of tremor, and all 35 of those affected dated the onset of the tremor to some time subsequent to their toxic exposure. Forty-three of 45 patients had histories and findings suggestive of peripheral neuropathy. This is the first report relating any type of dystonia to prior dioxin exposure and the first report relating action dystonia, such as dystonic writer's cramp, and postural/terminal intention tremor, to toxic exposure of any type.
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PMID:Dystonia and tremor following exposure to 2,3,7,8-tetrachlorodibenzo-p-dioxin. 284 55

We studied 18 patients with essential tremor for difficulty with handwriting, drinking, eating, fine manipulations, and embarrassment. Propranolol and primidone reduced the amplitude of both postural and kinetic tremor. Handwriting, drinking, and eating were improved with therapy, but fine manipulations and motor performance on tapping and pegboard tests were unaltered. Embarrassment remained unchanged. Essential tremor is not a benign condition; disability can be only partly reversed with drug therapy.
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PMID:Disability in essential tremor: effect of treatment. 294 Apr 73

Essential tremor may not represent a single condition. Subclassifications include kinetic predominant tremor; combined resting-postural tremor; primary writing tremor; isolated voice, chin, or tongue tremor; and orthostatic truncal tremor. We report patients with these disorders. An association of these conditions with essential tremor is suggested by a high occurrence of a family history of essential tremor, frequent presence of a mild postural tremor, and tremor reduction with alcohol ingestion. Pharmacologic responsiveness is different for these disorders. Propranolol and primidone often have beneficial effects but clonazepam was the only drug effective in some cases of kinetic predominant tremor and in orthostatic truncal tremor. Combined resting-postural tremor and voice tremor were often unresponsive to treatment.
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PMID:Essential tremor variants: effect of treatment. 350 77

Thalamic targets in the treatment of involuntary movements include the lateral and usually the intermediary ventral nuclei. Destruction of their afferents in Forel's fields provides the same therapeutic result but the size of the lesion must then be very small due to the proximity of essential structures, particularly corpus Luysi. Efficacy of treatment depends partly on the aetiology of the involuntary movement (and thus from the indication for surgery) and also on the technical possibilities of electrophysiologic mapping. The true dystonic element of the involuntary movement is usually little improved whereas tremors of all types are improved or suppressed. Essential tremor, familial or not, of large amplitude and very disabling, is an ideal indication for stereotaxic surgery when it presents as intention tremor. In Parkinson's disease, the treatment is effective against tremor and rigidity but akinesia is unaltered and the progressive course of the disease uninterrupted. Indications for surgery have become rare since the availability of L-dopa, perhaps too rare for the slowly progressive forms with predominant tremor poorly relieved by dopa-therapy, surgery has a curative and probably preventive effect on the involuntary movements of limbs induced by this treatment. Suppression of post-traumatic tremor and that due to multiple sclerosis is dependent on various factors: electrophysiologic precise mapping of the target since "electrical silences or holes" exist that disturb or prevent collection of evoked potentials or spike activity; multiple neurologic lesions that may be worsened by an additional thalamic lesion; finally residual cerebellar disturbance unmasked by the suppression of tremor, a poor "functional" result despite a good operative result.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Treatment of abnormal movements by thalamic lesions]. 353 89

Using a computer-controlled torque motor and manipulandum, 50 ms torque pulses and 70 second trains of binary pseudorandom torque disturbances were applied to the wrists of 10 adult controls and 22 patients with essential tremor in order to study the interaction between mechanically-induced stretch-reflex oscillations and essential tremor. These two oscillations were separated by applying inertial and spring loads to the wrist. There was no evidence of increased or unstable stretch-reflex activity in the essential tremor patients, and stretch-reflex latencies did not correlate with the frequency of essential tremor. Essential tremor and mechanically-induced stretch-reflex oscillations are separate phenomena capable of complex interaction.
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PMID:Stretch reflex oscillations and essential tremor. 361 49

The response to mental stress in patients with benign essential tremor is an exaggeration of the resting tremor. We have studied the ability of metoprolol tartrate to attenuate specifically the tremorgenic response to mental stress in five patients with essential tremor who were each studied on four occasions. Treatment regimens consisted of 0-, 25-, 50-, and 75-mg doses of metoprolol tartrate, given twice daily for seven- to ten-day periods. Tremor was measured while patients were resting comfortably and then again following mental stress over eight-hour study periods. During the baseline study period, the investigational mental stress consistently exaggerated tremor in each patient. Metoprolol treatment reduced both the resting tremor and tremor following mental activity, but the drug-induced change in the response to mental stress was more pronounced than the drug-induced reduction in resting tremor. The ability of metoprolol to blunt the response to mental stress was associated with serum concentrations of the drug. The time courses of metoprolol serum concentrations were similar to the time course of metoprolol's ability to blunt the response to mental stress. Metoprolol possesses the ability to blunt the tremorgenic response to mental stress in patients with essential tremor, but the duration of this effect lasts less than seven hours after administration of a dose.
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PMID:Attenuation of response to mental stress in patients with essential tremor treated with metoprolol. 372 47

We studied physiologic and essential hand tremor using inertial loading; hand acceleration and forearm EMG data were analyzed by auto- and cross-spectral analysis. Early essential tremor was qualitatively similar to the 8- to 12-Hz component of physiologic tremor, suggesting that this tremor component is a forme fruste of essential tremor. Advanced essential tremor had a frequency of 4 to 8 Hz. Patients with tremor frequencies in both ranges were observed in each of 10 families. In antagonistic forearm muscles, both synchronous and alternating tremor bursts were observed in 11 of 44 patients. Essential tremor should not be classified solely on the basis of frequency or EMG pattern.
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PMID:Physiologic and essential tremor. 394 94

We evaluated four patients with an initial and predominant voice tremor. All were referred for evaluation for suspected parkinsonism, though vocal tremor was the only symptom. These three women and one man ranged in age from 37 to 59 years. Neurologic evaluation and laryngeal examination were unremarkable. No signs of parkinsonism were present. All patients had a family history of tremor, though in only one family was vocal tremor the sole manifestation. Tremor was suppressed by alcohol ingestion in all patients and with whisper in two. Duration of tremor before evaluation ranged from eight months to six years. Visual representation of tremor was obtained in three, with frequencies ranging from 4 to 10 cps. Three patients responded to treatment with propranolol (Inderal), and one did well with voice training. Follow-up was six months to ten years. Although previous cases of essential vocal tremor with concurrent tremor elsewhere have been noted, only six cases of isolated voice tremor had been reported and response to therapy was not mentioned. Essential tremor may also be isolated to the head, chin, and hands.
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PMID:Essential vocal tremor: clinical characteristics and response to therapy. 397 48

Nine patients with tremor on writing and one patient with tremor only on swinging a golf club were investigated. None of the patients had any other neurological symptoms or signs. The frequency of the tremor ranged from 5 to 6 Hz. Rapid passive supination or pronation of the forearm by a torque motor evoked a short burst of alternating tremor in seven patients. The tremor was improved by alcohol or propranolol in six patients. These characteristics of writing tremor (and of other isolated action tremors) suggest that it is a variant of benign essential tremor.
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PMID:Writing tremor: its relationship to benign essential tremor. 400 90

The literature concerning essential tremor is confusing. Some accounts describe tremor of a resting type and its accompaniment by other neurological abnormalities. Critical analysis of the pertinent literature leaves some question as to the validity of these observations.Clinical analysis of 34 patients with essential tremor, personally observed during a four-year period, reveals this to be a monosymptomatic condition. The tremor was usually of both a postural and action type and resting tremor was not observed. There were no other neurological abnormalities. Serious disability was infrequent and, when present, was related to upper limb tremor. Essential tremor should be readily distinguishable from other central nervous system diseases but it may be confused with Parkinson's disease or cerebellar ataxia.
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PMID:The nature of essential tremor. 475 Mar 2


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