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Significance of Parkinsonian Manifestations in Essential Tremor

Published online by Cambridge University Press:  18 September 2015

A.H. Rajput*
Affiliation:
Neurology Division, Department of Medicine (A.H.R.); Department of Pathology (B.R., L.A.); College of Medicine (A.R.), University of Saskatchewan, Saskatoon
B. Rozdilsky
Affiliation:
Neurology Division, Department of Medicine (A.H.R.); Department of Pathology (B.R., L.A.); College of Medicine (A.R.), University of Saskatchewan, Saskatoon
L. Ang
Affiliation:
Neurology Division, Department of Medicine (A.H.R.); Department of Pathology (B.R., L.A.); College of Medicine (A.R.), University of Saskatchewan, Saskatoon
Alex Rajput
Affiliation:
Neurology Division, Department of Medicine (A.H.R.); Department of Pathology (B.R., L.A.); College of Medicine (A.R.), University of Saskatchewan, Saskatoon
*
Department of Medicine (Neurology), Royal University Hospital, Saskatoon, Saskatchewan, Canada S7N 0X0
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Abstract:

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Parkinsonian features, notably resting tremor may be seen in some essential tremor patients but the significance of those is unknown. The reported risk of parkinsonism in essential tremor patients varies from being unchanged to 35 times higher than expected. We studied 9 patients with essential tremor who had autopsies. In 6 of the 9 (66%) resting tremor was noted and in 3 (33%) cases fully developed parkinsonism was noted. The parkinsonism was consequent to neuroleptic usage in 2 and to basal ganglia status lacunaris and cribrosus in one case but no consistent abnormalities were noted in 3 essential tremor only and 3 essential tremor plus resting tremor cases. We conclude that resting tremor is an age-related natural evolution in some essential tremor patients. We recommend that the additional diagnosis of parkinsonism in the essential tremor be made only when resting tremor, bradykinesia and rigidity are all evident. The risk of ideopathic Parkinson's disease in essential tremor cases is similar to the general population.

Type
Research Article
Copyright
Copyright © Canadian Neurological Sciences Federation 1993

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