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)

A 17-year-old male with no medical history noticed weakness of his limbs with imbalance and subsequent finger tremors. Physical examination revealed features of polyneuropathy, including diffuse weakness, distal symmetrical numbness with impaired deep sensation and areflexia in all limbs. Postural tremor was present in fingers. Ataxia was apparent in both lower limbs, causing a wide-based gait with a positive Romberg sign. Cerebrospinal fluid contained elevated total protein without pleocytosis. A nerve conduction study disclosed demyelinating features with prolonged terminal latencies, slow velocities with delayed F-wave latencies, and prominent temporal dispersion. These findings led to diagnosis of typical chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) with notable feature of postural finger tremor and ataxia of unknown cause. These atypical features prompted us to examine neurofascin-155 (NF155) antibodies, which were positive. No significant improvement occurred after initial administration of intravenous immunoglobulin and subsequent plasma exchange. However, corticosteroids with intravenous pulse therapy followed by oral prednisolone significantly improved the symptoms. Patients with CIDP with anti-NF155 antibodies may have similar clinical features and constitute a CIDP subgroup. In such patients, corticosteroids may be more effective than intravenous immunoglobulin. Further studies are needed to define the features of this subgroup and determine effective therapy for CIDP.
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PMID:A case of a 17-year-old male with neurofascin-155 antibody-positive chronic inflammatory demyelinating polyradiculoneuropathy presenting with tremor and ataxia. 2758 Jul 61

Although rest tremor is the typical form of tremor associated with Parkinson's disease (PD), particularly the tremor-dominant subtype,1 parkinsonian patients may also exhibit postural tremor. In many parkinsonian patients, this postural tremor emerges after a latency of a few seconds or even minutes. In our original description, we coined the term "re-emergent tremor" to differentiate this postural tremor from essential tremor, which occurs without any latency, and to link it to PD rest tremor that is "reset" after some latency when a new holding posture is assumed.2 The relationship of this re-emergent tremor to the typical rest tremor is supported by the observation that this tremor shares many characteristics with the typical rest tremor, such as the same, 3 to 5-Hz frequency, occasional supinating-pronating component, and relatively good response to dopaminergic therapy. Rarely, postural tremor, occurring after a brief (2-4 seconds) latency can be seen even without observable rest tremor.3 In most patients with PD, it is the postural (re-emergent) tremor that is more troublesome for them than the typical rest tremor, because this re-emergent tremor interferes with their ability to hold objects, such as newspapers, against gravity and results in spilling of liquids. Postural tremor of PD is often misdiagnosed as essential tremor, and this diagnostic challenge can be further confounded when both conditions coexist.4 When that occurs, the postural tremor is present without latency, although the amplitude may gradually increase as the underlying re-emergent tremor becomes more evident.
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PMID:How Do I Examine for Re-Emergent Tremor? 3036 1

High frequency Deep Brain Stimulation (DBS) targeting the motor thalamus is an effective therapy for essential tremor (ET). However, since tremor mainly affects periods of voluntary movements and sustained postures in ET, conventional continuous stimulation may deliver unnecessary current to the brain. Here we tried to decode movement states based on local field potentials (LFPs) recorded from motor thalamus and zona incerta in real-time to trigger the switching on and off of DBS in three patients with ET. Patient-specific models were first identified using thalamic LFPs recorded while the patient performed movements that tended to trigger tremor in everyday life. During the real-time test, LFPs were continuously recorded to decode movements and tremor, and the detection triggered stimulation. Results show that voluntary movements can be detected with a mean sensitivity ranging from 76.8% to 88.6% and a false positive rate ranging from 16.0% to 23.1% Postural tremor was detected with similar accuracy. The closed-loop DBS triggered by tremor detection suppressed intention tremor by 90.5% with a false positive rate of 20.3%.Clinical Relevance- This is the first study on closed-loop DBS triggered by real-time movement and tremor decoding based solely on thalamic LFPs. The results suggest that responsive DBS based on movement and tremor detection can be achieved without any requirement for external sensors or additional electrocorticography strips.
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PMID:Closed-loop DBS triggered by real-time movement and tremor decoding based on thalamic LFPs for essential tremor. 3301 82


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