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

The Leksell Gamma Knife is a useful and safe method to perform thalamotomy and pallidotomy in selected older patients with Parkinson's disease and related movement disorders. In this preliminary report, 2 of 3 patients with severe intention tremor were relieved of their symptoms by thalamotomy, as were 4 of 7 patients with Parkinson's tremor. Four of 8 patients had significant improvement of contralateral rigidity following pallidotomy.
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PMID:Gamma Knife thalamotomy and pallidotomy in patients with movement disorders: preliminary results. 811 59

A variety of post-traumatic movement disorders may follow severe head injury. Generally, the movement disorder is a moderate to severe intention tremor, and this is often the major source of disability for the patient. The clinical features of 7 patients whose predominant problem was a post-traumatic cerebellar syndrome, who were treated by stereotactic ablation of the ventralis intermedius thalamic nucleus, are reported. 6 patients had good relief of their tremor and only 1 patient did not improve. Conservative treatment is usually ineffective, but in appropriately selected cases, stereotactic thalamotomy has a high degree of clinical success.
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PMID:Stereotactic surgery for post-traumatic cerebellar syndrome: an analysis of seven cases. 832 95

A family with two siblings presenting cerebral calcifications is reported. The sister was suffering from action tremor since the age of 10. The disease worsened by the age of 39. When aged 42, she was unable to walk and had severe rigidity and intellectual deterioration. She died at 43. The brother had mild debility. Action tremor started at the age of 14, without significant aggravation when seen at the age of 30. In both cases, brain CT scan showed calcifications of the dentate nuclei and cortical atrophy with ventricular enlargement. In addition, the sister had bilateral putaminal and pallidal calcifications. The other family members were unaffected and had normal CT scans. The nosology and the pathophysiology of this family report are discussed, particularly regarding the late occurrence of facial atrophy, reminiscent of the Cole-Engmann syndrome (Dyskeratosis Congenita).
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PMID:[Striato-pallido-dentate calcifications and acquired facial atrophy]. 859 48

The present study investigates evidence of dentatothalamic pathway lesions in nineteen patients with severe kinetic post-traumatic tremor respectively by magnetic resonance imaging (MRI). Kinetic tremor is thought to be characteristic of lesions of the cerebellar outflow. While this hypothesis is supported by experimental data, neuropathological and neuroradiological findings have been limited. The appendicular tremors were unilateral in 13 patients and bilateral in 6, accounting for 25 instances of tremor. The tremor developed after severe head trauma in 18 patients. These patients had evidence of diffuse axonal injury on MRI. Postural and kinetic tremor was present in all patients, and was accompanied by tremor also present at rest in 14 instances. Multiplanar MRI studies were performed on a high-field MRI system operating at 2.0 T in 13 patients and on intermediate-field strength MRI systems in 6 patients according to a standardized protocol. To detect small deposits of hemosiderin after post-traumatic lesions, the protocol included a heavily T2-weighted spin-echo pulse sequence. Lesions of the dentatothalamic pathways were found in 22 instances. The lesions were classified into different types of according to their distribution. A lesion of the dentate nucleus ipsilateral to the tremor (type 1) was found in one instance (4%), lesions involving the ipsilateral predecussational dentatothalamic pathway (type II and III) were found in 14 instances (56%), and lesions involving the contralateral post-decussational course (type IV) in 7 instances (28%). One patient with a mild head trauma had a lesion of the contralateral thalamus. The lesions appeared as hypointense, hyperintense or mixed. Two of three patients with a parkinsonian-like rest tremor had type IV lesions involving the substantia nigra. The nosological concepts of tremors are discussed. 'Midbrain' tremor may have distinct pathoanatomical lesion sites.
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PMID:Lesion of dentatothalamic pathways in severe post-traumatic tremor. 862 92

Unilateral ventrolateral (VL) thalamotomy for medically refractory tremorigenic movement disorders (MD) was performed in 9 patients with established multiple sclerosis. All patients had abolition of their coarse action/kinetic tremor with improvement in arm and hand function. In two patients some intention tremor either remained or was unmasked. Target coordinates ranged from 2 to -5 mm relative to the intercommissural line and from 8 to 16 mm lateral to the midline. There were no permanent surgical complications and the one stage procedure under local anesthetic was well tolerated. Although there were also improvements in posture and speech in some patients the overall and longer term functional impact of surgery was, except in two patients, disappointing. Since multiple sclerosis is a spectrum of disease entities, and tremor may be only one manifestation of the disease, clinical studies that use comprehensive patient assessments and objective criteria may allow prediction of longer term functional outcome in specific patient subgroups. The specific aims of the stereotactic procedure in severely disabled patients with MS and MD must also be clear.
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PMID:CT guided thalamotomy for movement disorders in multiple sclerosis: problems and paradoxes. 874 76

We describe five patients presenting with high fever and isolated cerebellar gait ataxia. In all these patients, neurological examination revealed dysmetria, intention tremor and postural tremor during sustained posture, all restricted to the legs. Brain MRI was normal. In four of these patients, the recording of leg tremor during sustained postures showed a 3-Hz frequency. Cerebellar gait ataxia resolved within 3-10 days. We suggest that the ataxic gait was due to a reversible dysfunction of the spinocerebellar part of the anterior lobe.
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PMID:Reversible cerebellar gait ataxia with postural tremor during episodes of high pyrexia. 888 94

Mice homozygous for mutant alleles at the gray tremor (gt) locus develop a marked non-intention tremor beginning at 8 days of age. Most homozygous mice die by 3 months. Homozygotes exhibit intense vacuolation of the central nervous system gray matter and vacuolation and hypomyelination of some white matter tracts. Based on neuropathological similarities with scrapie, other investigators inoculated wild-type mice with gray tremor brain homogenates to test the hypothesis of transmissibility. Published reports indicated that spongiform encephalopathy (R. L. Sidman, H. C. Kinney, and H. O. Sweet, Proc. Natl. Acad. Sci. USA 82:253-257, 1985) and disease, including hind limb paralysis in NFS mice (P. M. Hoffman, R. G. Rohwer, C. MacAuley, J. A. Bilello, J. W. Hartley, and H. C. Morse III, Proc. Natl. Acad. Sci. USA 84:3866-3870, 1987), were transmitted by inoculation of gt/gt brain homogenates. In our hands, however, no NFS/NCr animals inoculated intracerebrally with gt/gt or +/+ brain preparations showed any signs of disease or pathological changes in the brain. Positive transmission by other investigators may reflect the microbiological status of their donor or recipient mice.
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PMID:Failure to transmit disease from gray tremor mutant mice. 903 70

We examined the occurrence of posttraumatic movement disorders after moderate or mild head injury with a three-level follow-up study including questionnaires, telephone interviews, and personal examinations 4-6 years after the trauma (mean 5.2 years). Sixteen of 158 patients (10.1%) for whom a detailed follow-up was available had developed movement disorders most probably related to craniocerebral trauma. The most frequent finding was a low-amplitude postural/intention tremor that appeared to resemble enhanced physiological or essential tremor. Twelve patients reported transient tremor, two patients had persistent tremor, one patient had transient tremor and persistent hyperekplexia, and another patient had mild persistent cervical myoclonic twitches. Overall, the movement disorder was transient in 12 patients (7.6%) and persisted in only 4 patients (2.6%). These movement disorders were not disabling and did not require medical therapy. Taking into account possible bias by selection of the sample group, the frequency of movement disorders secondary to moderate or mild head trauma might be lower than 10.1%. Posttraumatic movement disorders occurred significantly more often in the group of patients with Glasgow Coma Scores between 9 and 14 than in those with a score of 15. Severe movement disorders such as low-frequency kinetic tremor or hemidystonia were not identified in this survey.
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PMID:Posttraumatic movement disorders after moderate or mild head injury. 915 42

The object of the present study was to evaluate the hand tremor occurring under various conditions in 81 patients with Parkinson's disease (PD) and to statistically analyze their relation to clinical rating items. We found that resting and action tremor have to be separated, whereas postural tremor can be related to either one of them. Resting tremor does not correlate with disability items or performance items except for an item rating social handicaps. Action tremor shows some influence on performance items. Current rating scales of PD represent a valid measure of resting tremor but are less valid for the measurement of action tremor.
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PMID:Tremors in Parkinson's disease: symptom analysis and rating. 931 77

We have previously shown that action tremor persists during maximal wrist extension in patients with Parkinson's disease, and that this contributes to weakness at this joint by preventing the fully fused contraction of the forearm extensor muscles. Antiparkinsonian medication reduces the action tremor in torque and electromyographic (EMG) records, thereby improving strength at the wrist. In the present experiments, peak torque and action tremor were recorded during maximal extension of the elbow in nine patients with Parkinson's disease while they were on and off antiparkinsonian medication, and in eight age- and sex-matched healthy subjects. Peak torque and mean rectified EMG levels were reduced by 34% and 36%, respectively, during maximal elbow extension when patients off medication were compared to those in the treated state. Action tremor was visible in torque records and had a frequency of approximately 10 Hz both in parkinsonian patients and in normal controls. Activity of a similar frequency was often detected in EMG records, especially in patients off therapy. The absolute amplitude of action tremor in torque (A[torque]) and EMG (A[EMG]) records from the elbow was unaffected by therapy and was little different from that recorded in healthy controls. The relative action tremor in torque ([A(torque)/peak torque] x 100) and EMG ([A(EMG)/mean rectified EMG] x 100) was reduced by treatment, but this was the result of the increase in peak torque and mean rectified EMG. Thus, in contrast to the results at the wrist, antiparkinsonian medication has little effect on the 10-Hz action tremor at the elbow. Increased strength is produced by a different mechanism which allows recruitment of triceps motor units outside of this synchronizing influence.
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PMID:Action tremor and weakness in Parkinson's disease: a study of the elbow extensors. 945 27


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