TY - JOUR
T1 - Clinical characteristics of essential tremor
T2 - Data from a community-based study
AU - Louis, Elan D.
AU - Ford, Blair
AU - Wendt, Kristin J.
AU - Cameron, Gabriella
PY - 1998
Y1 - 1998
N2 - BACKGROUND: 99.5% of individuals with essential tremor (ET) who live in the community have mild tremor and do not attend clinics. Clinic-based studies of ET have not allowed investigators to characterize the full clinical spectrum of this disorder. In community-based studies of ET, the primary focus has been the prevalence rather than the clinical characteristics of ET. OBJECTIVE: To describe the clinical characteristics of ET as seen in a community-based study. METHODS: 73 subjects with ET, identified in a community-based study of ET in Washington Heights-Inwood, New York, underwent a standardized 84-item physician administered tremor interview and a 26-item videotaped tremor examination which included 12 bedside tests for ET. Two neurologists who specialized in movement disorders and who demonstrated excellent interrater agreement rated the severity of tremor using a 0 to +3 clinical rating scale and assigned a total tremor score (range, 0-36) and a diagnosis of ET. RESULTS: Diagnoses in the 73 cases were: definite ET (18, 24.7%), probable ET (32, 43.8%), and possible ET (23, 31.5%). The mean total tremor score was 17.8 of 36. Thirty-six of 73 (49.3%) were asymptomatic, answering 'no' to the question 'do you often have shaking or tremor that you can't control?' Sixty-seven of 73 (91.8%) had not been prescribed medication for tremor. On average, subjects received tremor ratings of ≤ +2 on only 5.4 of the 12 bedside tests for ET. Kinetic tremor was rated as more severe than postural tremor in 72 (98.6%) of 73 cases. CONCLUSIONS: We present the clinical findings of a group of largely untreated, unselected cases of ET that would not otherwise have come to neurologic attention. The tremor was mild, often asymptomatic, and not uniformly present throughout the examination. It was rarely treated. The kinetic component of the tremor was more severe than the postural component. These clinical data further our understanding of the clinical spectrum of ET.
AB - BACKGROUND: 99.5% of individuals with essential tremor (ET) who live in the community have mild tremor and do not attend clinics. Clinic-based studies of ET have not allowed investigators to characterize the full clinical spectrum of this disorder. In community-based studies of ET, the primary focus has been the prevalence rather than the clinical characteristics of ET. OBJECTIVE: To describe the clinical characteristics of ET as seen in a community-based study. METHODS: 73 subjects with ET, identified in a community-based study of ET in Washington Heights-Inwood, New York, underwent a standardized 84-item physician administered tremor interview and a 26-item videotaped tremor examination which included 12 bedside tests for ET. Two neurologists who specialized in movement disorders and who demonstrated excellent interrater agreement rated the severity of tremor using a 0 to +3 clinical rating scale and assigned a total tremor score (range, 0-36) and a diagnosis of ET. RESULTS: Diagnoses in the 73 cases were: definite ET (18, 24.7%), probable ET (32, 43.8%), and possible ET (23, 31.5%). The mean total tremor score was 17.8 of 36. Thirty-six of 73 (49.3%) were asymptomatic, answering 'no' to the question 'do you often have shaking or tremor that you can't control?' Sixty-seven of 73 (91.8%) had not been prescribed medication for tremor. On average, subjects received tremor ratings of ≤ +2 on only 5.4 of the 12 bedside tests for ET. Kinetic tremor was rated as more severe than postural tremor in 72 (98.6%) of 73 cases. CONCLUSIONS: We present the clinical findings of a group of largely untreated, unselected cases of ET that would not otherwise have come to neurologic attention. The tremor was mild, often asymptomatic, and not uniformly present throughout the examination. It was rarely treated. The kinetic component of the tremor was more severe than the postural component. These clinical data further our understanding of the clinical spectrum of ET.
KW - Clinical characteristics
KW - Community
KW - Essential tremor
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U2 - 10.1002/mds.870130508
DO - 10.1002/mds.870130508
M3 - Article
C2 - 9756149
AN - SCOPUS:0031656488
SN - 0885-3185
VL - 13
SP - 803
EP - 808
JO - Movement Disorders
JF - Movement Disorders
IS - 5
ER -