Differentiating Essential and Dystonic Head Tremor: Exploring Arm Position Effects.

IF 2.6 4区医学 Q2 CLINICAL NEUROLOGY Movement Disorders Clinical Practice Pub Date : 2024-11-15 DOI:10.1002/mdc3.14269

Tereza Hubená, Petr Hollý, Aneta Pavlíková, Olga Ulmanová, Jan Rusz, Radim Krupička, Evžen Růžička

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Abstract

Background: Head tremor poses diagnostic problems, especially when present as an isolated or predominant symptom.

Objectives: To assess how maneuvers activating upper limb postural tremor can help differentiate head tremor in essential tremor (ET) from dystonic tremor (DT) in cervical dystonia.

Methods: 48 patients with head tremor (25 ET, 23 DT), underwent clinical examination and accelerometric evaluation of head and upper limb tremor during routine tremor-inducing tasks.

Results: While accelerometric power and clinical scores of head tremor did not significantly differ between patient groups, task-induced variations revealed distinctions. ET patients exhibited increased head tremor power and clinical scores during forward outstretched and lateral wing-beating arm positions, unlike DT patients. Coherence between head and upper limb tremor remained consistent. Tremor stability index showed no significant differences.

Conclusions: Task-induced changes in head tremor could aid in distinguishing between ET and DT. Further research is needed to refine diagnostic approaches for head tremor.

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区分强直性震颤和肌张力障碍性震颤：探索手臂位置的影响

背景：头部震颤会给诊断带来困难，尤其是在作为孤立或主要症状出现时：方法：48 位头部震颤患者（25 位 ET，23 位 DT）接受了临床检查和常规震颤诱发任务中头部和上肢震颤的加速度评估：虽然加速度测量功率和头部震颤的临床评分在不同患者组之间没有显著差异，但任务诱发的变化却显示出了区别。与 DT 患者不同的是，ET 患者在前伸和侧翼拍打手臂姿势时，头部震颤力和临床评分均有所增加。头部震颤和上肢震颤之间的一致性保持一致。震颤稳定性指数无明显差异：任务引起的头部震颤变化有助于区分 ET 和 DT。需要进一步研究以完善头部震颤的诊断方法。

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来源期刊

Movement Disorders Clinical Practice CLINICAL NEUROLOGY-

CiteScore

4.00

自引率

7.50%

发文量

218

期刊介绍： Movement Disorders Clinical Practice- is an online-only journal committed to publishing high quality peer reviewed articles related to clinical aspects of movement disorders which broadly include phenomenology (interesting case/case series/rarities), investigative (for e.g- genetics, imaging), translational (phenotype-genotype or other) and treatment aspects (clinical guidelines, diagnostic and treatment algorithms)