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Query: UMLS:C0040822 (tremor)
 18,428 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

In a rural community of 80,000 people 69 patients were identified as having a diagnosis of Parkinson's disease. After interview and examination we found that 55 met the generally accepted diagnostic criteria for Parkinson's disease, 4 had possible Parkinson's disease, 6 had essential tremor, 2 had dementia and 2 had other conditions. The patients with Parkinson's disease had clinical and epidemiologic characteristics similar to those of patients in previous, mainly hospital-based, studies. These characteristics included mean age at onset (63 years), frequency rate of dementia (20%) and presence of postural tremor (11%). The pattern of treatment varied, some patients receiving more medication than is usual for the severity of their illness, and some patients receiving less than is usual. Parkinson's disease can be difficult to diagnose and manage because of the clinical variation between patients in presentation and response to treatment.
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PMID:A community survey of Parkinson's disease. 276 81

A 79-year-old woman presenting with orthostatic tremor (OT) was reported. In addition to OT, neurological examination showed mild dementia, bradykinesia, rigidity of the neck and the upper limbs and positive Babinski reflex on the left. These clinical signs and CT as well as MRI findings suggested vascular parkinsonism as its pathological background. Upon standing with her feet together, she rapidly developed rhythmic repetitive contraction of all leg muscles. The shaking disappeared by walking, sitting, or lying down. The EMG recording revealed 4-Hz tremor which consisted of alternating contraction of anti-gravity muscles and their antagonists. The EMG bursts associated with the tremor were synchronous in corresponding muscles of both legs. OT could be bilaterally reset by unilateral voluntary or passive movement of leg. In the supine position, the tremor was not evoked by voluntary contraction of leg muscles against resistance. As the tremor was aggravated by the administration of haloperidol was suppressed by L-DOPA, it was thought to have the pharmacological basis common to the resting tremor of parkinsonism. Furthermore, we postulated that the postural tonus-regulating system, which is thought to set and maintain the tonus of antigravity muscles for standing upright, might be involved in the generation of the rhythmic discharge pattern (reciprocal bursts in a given leg and synchronized bursts in both legs) of OT.
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PMID:[A case of orthostatic tremor in parkinsonism]. 280 17

Previous research has shown that low voltage fast activity (LVFA) in the neocortex and rhythmical slow activity (RSA) in the hippocampus can result from activity in either of two ascending pathways. Activity in neurons in the basal forebrain may produce atropine-sensitive (presumably cholinergic) LVFA and RSA during both Type 1 behavior (e.g., head movement, walking) and Type 2 behavior (e.g., waking immobility, face-washing, tremor). Activity in an aminergic pathway may produce atropine-resistant LVFA and RSA during Type 1 behavior only. The role of 5-hydroxytryptamine (5-HT) in this pathway was studied in rats treated with p-chlorophenylalanine (PCPA; 500 mg/kg/day X 3, i.p.). Amine levels were measured by high pressure liquid chromatography with electrochemical detection. Brain slow wave and multi-unit activity was assessed by inspection and by a procedure of filtering and integration. PCPA treatment alone had little effect on LVFA or RSA, but following PCPA and atropine (50 mg/kg) together, both LVFA and RSA were attenuated or eliminated. Thus, atropine-resistant LVFA and RSA may be dependent on 5-HT transmission. A combination of PCPA and atropine produced a very severe deficit in performance in a simple water maze. Rats treated with this drug combination may provide an animal model of human global dementia.
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PMID:Evidence that serotonin mediates non-cholinergic neocortical low voltage fast activity, non-cholinergic hippocampal rhythmical slow activity and contributes to intelligent behavior. 294 Nov 11

Patients with Huntington's disease (HD) and relatives at risk were examined with respect to their capacity to produce rapid voluntary motor activity. For this purpose, the fastest possible self-paced single isometric forefinger extensions and the fastest alternating forefinger movements were tested. In addition to these fastest voluntary performances, the time course of spontaneous hyperkinetic finger movements and the peak frequency of finger and hand tremor were analysed as a measure of the temporal characteristics of involuntary movements. Comparison of these parameters in HD patients and individuals at risk with age and sex-matched normal controls revealed a significant slowing of all types of contractions or movements in the majority (up to 95%) of the patients and in up to 40% of the relatives at risk. Reaction times were only slightly prolonged, and the abnormalities of the movement parameters showed no correlation with detailed psychometric data. Hence it is unlikely that the disturbance in the execution of rapid motor acts is due to dementia. Tremor was also slower than normal and the hyperkinesias were still slower than the fastest voluntary contractions. It appears from this study that slowness of motor performance is not only evident in Parkinson's disease but may represent a more general dysfunction in basal ganglia disease.
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PMID:Impairment of rapid movement in Huntington's disease. 295 6

While dementia in Parkinson's disease (PD) is well described, PD features in Alzheimer's disease (AD) are being increasingly recognized. In 20 neuropathologically confirmed AD brains, 11 cases (55%) showed PD changes (Lewy body formation, neuronal loss, and gliosis of pigmented nuclei), with no significant difference in age or symptom duration between those cases with and without PD pathology. A history of rigidity in the absence of neuroleptic medication was noted in 80% of those with PD pathology but only 14% of those without PD pathology. Tremor was not observed in either group. This suggests that extrapyramidal signs, especially rigidity, noted in many AD patients are related to coexistent PD pathology.
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PMID:Neuropathologic and clinical features of Parkinson's disease in Alzheimer's disease patients. 303 44

A 24-year-old man presented with dystonia, dementia, amyotrophy, choreoathetosis, and ataxia. Partial hexosaminidase A deficiency was documented in serum and leukocytes and confirmed by rectal biopsy with ganglion cells containing membranous cytoplasmic bodies. A brief review of the literature reveals that tremor, dystonia and choreoathetosis are common but neglected symptoms associated with chronic GM2 gangliosidosis.
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PMID:Movement disorders associated with chronic GM2 gangliosidosis. Case report and review of the literature. 308 50

The distribution of cerebral blood flow and metabolism is related to neuronal activity. Cerebral blood flow (CBF), cerebral metabolic rate of oxygen (CMRO2), and oxygen extraction fraction (OEF) in ten patients with Parkinson's disease and five age-matched normal control subjects were measured with positron emission tomography (PET) using 15O2, C15O2 steady state inhalational technique to investigate functional changes of the cortex and the basal ganglia in Parkinson's disease. All patients had no history of cerebrovascular disease and CT scan showed no abnormal findings except for moderate cerebral atrophy in only one patient. When the level of clinical disability was related on the scale of Hoehn and Yahr, one patient was stage I, four were stage II, four were stage III, and one was stage IV. Psychic symptoms which include hallucination, depression, and dementia were recognized in four patients. One of these four patients was mildly demented. Four patients were newly diagnosed and had never been treated with antiparkinsonian medication before. Before the patients had their PET study their antiparkinsonian medication was discontinued for more than three days. But in two patients PET study was performed without discontinuity of antiparkinsonian medication. The values for regional CBF and regional CMRO2 were lower in the patients than in the normal control subjects, especially in the frontal cortex there was a significant decrease of CBF and CMRO2. There was no discrepancy between CBF and CMRO2 both in the patients and the normal control. CBF and CMRO2 in the cortex and the basal ganglia were not correlated with the severity of tremor, bradykinesia, and rigidity.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[Cerebral blood flow and oxygen metabolism in patients with Parkinson's disease]. 326 73

There is a paucity of trained neurologists in developing countries. We designed a questionnaire to rapidly screen a community of 851 people (Parsis living in a colony in Bombay, India) for possible neurologic diseases. This questionnaire was pretested and found to have a sensitivity of 100 percent for detecting epilepsy, febrile seizures (only in children), completed stroke, peripheral neuropathy, movement disorders, cerebral palsy, mental retardation, and severe dementia. The screening questionnaire was administered by trained lay health workers. One hundred and sixty-three people were identified by this questionnaire as possibly having neurologic disease. Neurologists later examined these 163 people and found that 80 of them actually suffered from at least one of the neurologic diseases of interest (positive predictive value = 48 percent). The most common neurologic disorders were peripheral neuropathy (32 cases), essential tremor (13 cases), stroke (12 cases), Parkinson's disease (six cases), and epilepsy (four cases).
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PMID:Pilot survey of the prevalence of neurologic disorders in the Parsi community of Bombay. 333 Jun 62

A review of the records for evidence of dementia using criteria adapted from the third edition of the Diagnostic and Statistical Manual of Mental Disorders in every patient (hospitalized and outpatient) with parkinsonism at a major medical center during an 18-month period revealed an overall prevalence of 10.9% in 339 patients with idiopathic Parkinson's disease. Demented patients were older, had a later age at onset of motor manifestations, and a more rapid progression of physical disability than nondemented patients. Duration of illness and levodopa use and the presence of tremor or depression were similar in demented and nondemented patients. Demented patients more often responded poorly or developed adverse effects to levodopa than nondemented patients. When Parkinson's disease began after age 70 years, dementia was noted over three times more frequently than when the disease began at an earlier age. The age-specific prevalence rate of dementia for patients older than 70 years was more than twice that for younger patients. Moreover, the number of records with evidence for dementia with idiopathic Parkinson's disease was 3.75 times greater than expected in comparison with data from a study of the prevalence of dementia in the elderly.
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PMID:An estimate of the prevalence of dementia in idiopathic Parkinson's disease. 334 50

We compared 46 patients having onset of Parkinson's disease before age 45 years with 52 having onset after age 70. Young-onset cases more often presented with muscular stiffness (43%) and old-onset with difficulty walking (33%). One-third of young-onset cases had off-period dystonia, mostly affecting the legs, but no dystonia was recorded in old-onset cases. Presentation with rest tremor occurred in 41% of young-onset and 63% of old-onset. There were no differences in the number of affected relatives, endocrine disease, personality characteristics, dementia, or dyskinesia. A pathological study of 12 young-onset and 22 old-onset cases showed 24% greater nigral cell loss in the young, but no differences in the basic Lewy body pathology. Median disease duration in young cases was 5 years longer in the clinical study and 12 years longer in the pathological study. These studies show that the Parkinson's disease process is similar in young- and old-onset cases.
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PMID:A comparison of clinical and pathological features of young- and old-onset Parkinson's disease. 341 87


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