Long duration asymmetrical postural tremor is likely to predict development of Parkinson's disease and not essential tremor: clinical follow up study of 13 cases
Long duration asymmetrical postural tremor is likely to predict development of Parkinson's disease and not essential tremor: clinical follow up study of 13 cases
复制标题
DOI：
10.1136/jnnp.2004.046292
复制
发表时间：
2005-01-01
影响因子：
11
通讯作者：
Brooks, DJ
中科院分区：
文献类型：
--
作者：
Chaudhuri, KR;Buxton-Thomas, M;Brooks, DJ
背景：不对称性体位性震颤伴或不伴轻度静止性震颤的患者可被诊断为原发性震颤(ET)，但这些患者的长期预后仍存在相当大的诊断不确定性。目的：本研究对13例最初表现为非对称性体位性震颤的患者进行了回顾性观察，这些患者最初被认为是基于震颤特征、酒精反应和家族史的ET，但后来符合帕金森病(PD)的标准。方法：使用多巴胺转运体SPECT扫描或左旋多巴激发试验对患者进行临床观察和辅助成像随访。结果：经过一段可变和长潜伏期后，所有患者都出现了提示临床诊断为帕金森病的额外体征，但最初获得了ET的标签。结论：即使没有静止性震颤，我们也建议对起病较晚的非对称性姿势震颤患者的ET诊断要谨慎。震颤的酒精敏感性、震颤家族史或对β受体阻滞剂的反应性可能对这些病例的ET诊断没有帮助，有些人可能会长期发展为帕金森病。
Background: Patients presenting with asymmetrical postural tremor with or without mild rest tremor may be diagnosed as having essential tremor ( ET), although there is considerable diagnostic uncertainty as to the long term outcome of these patients.Objective: In this study, retrospective observations were made on 13 patients presenting originally with asymmetrical postural tremor, initially thought to have ET based on tremor characteristics, alcohol responsiveness, and family history but who subsequently met the criteria of Parkinson's disease (PD).Methods: The patients were observed and followed up clinically with ancillary imaging using dopamine transporter SPECT scan or levodopa challenge tests in some cases. The diagnosis at original presentation with postural tremor was made with retrospective case note review.Results: After a variable and long latent period all patients developed additional signs suggesting a clinical diagnosis of PD although picking up an initial label of ET.Conclusions: We suggest exercising caution regarding a diagnosis of ET in patients presenting with late onset asymmetrical postural tremor even if there is no rest tremor. Alcohol sensitivity of tremor, family history of tremor, or responsiveness to beta blockers may not be helpful in diagnosing ET in these cases and some may develop PD in the long term.