Isolated Voice Tremor: A Clinical Variant of Essential Tremor or a Distinct Clinical Phenotype?
Isolated Voice Tremor: A Clinical Variant of Essential Tremor or a Distinct Clinical Phenotype?
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DOI：
10.7916/tohm.v0.738
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发表时间：
2020-01-23
影响因子：
2.2
通讯作者：
Barkmeier-Kraemer, Julie M.
中科院分区：
文献类型：
--
作者：
Barkmeier-Kraemer, Julie M.
背景：国际帕金森和运动障碍协会震颤工作组的共识声明排除了患有“孤立性声音震颤”的个体作为特发性震颤（ET）的临床变异。这一临床观点为重新考虑“孤立性声音震颤”作为 ET 的一种临床变异提供了理论依据。方法：从文献中提取证据来表征“孤立性声音震颤”或原发性声音震颤 (EVT) 的临床表型。临床特征是从 pubmed.gov 上提供的相关文献中提取的，使用术语“EVT”、“特发性声音震颤”、“原发性声音震颤”和“器质性声音震颤”。结果：EVT 患者的平均发病年龄超过 60 岁（范围 19-84 岁），其中 75-93% 是女性。声带震颤的典型持续时间为 1 至 13 年（平均 6 年）。大多数患者表现出震颤的结构分布包括喉部、软腭、咽部和舌根，部分患者表现出头部和呼吸肌肉组织的震颤。 74% 的人在说话和安静呼吸时出现震颤。震颤频率为 4 至 10 Hz。近 70% 的患者报告在上肢受累之前就出现了声带震颤。据报道，38-42% 的个体有震颤家族史。讨论：之前被分类为 EVT 的患者表现出相似的家族史、发生率、震颤分类和 ET 的身体分布。 EVT 被认为是 ET 的临床变体，其发病和进展模式是身体分布从中线颅骨到脊髓神经通路。
Background: The consensus statement by the Task Force on Tremor of the International Parkinson and Movement Disorder Society excludes individuals with "isolated voice tremor" as a clinical variant of essential tremor (ET). This clinical viewpoint presents a rationale for reconsideration of "isolated voice tremor" as a clinical variant of ET.Methods: Evidence from the literature was extracted to characterize the clinical phenotype of "isolated voice tremor," or essential vocal tremor (EVT). Clinical features were extracted from relevant literature available at pubmed.gov using the terms "EVT," "essential voice tremor," "primary voice tremor," and "organic voice tremor."Results: The average age of onset in those with EVT was older than 60 years (range 19-84 years), with 75-93% being female. The typical duration of vocal tremor ranged from 1 to 13 years (average 6 years). The distribution of structures exhibiting tremor included the larynx, soft palate, pharynx, and base of tongue in the majority of patients, with some exhibiting tremor of the head and respiratory musculature. The condition of tremor occurred during speech and quiet respiration in 74% of individuals. Rate of tremor ranged from 4 to 10 Hz. Nearly 70% reported onset of vocal tremor prior to upper limb involvement. Family history of tremor was reported in 38-42% of individuals.Discussion: Those previously classified with EVT demonstrate a similar familial history, rate, tremor classification, and body distribution of ET. EVT is proposed as a clinical variant of ET in the pattern of onset and progression of body distribution from the midline cranial to spinal neural pathways.