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Clinical and Electromyographic Examinations of Patients with Essential Tremor

Published online by Cambridge University Press:  04 August 2016

Ivan Milanov
Ivan Milanov*
Affiliation:
University Neurological Hospital-IV kilometre, Sofia, Bulgaria
*
University Neurological Hospital-IV kilometre, III Neurological Clinic, Blvd. Tzarigradsko shosse-IV kilometre, Sofia 1113, Bulgaria
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Abstract:

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Background:

It is believed that no clinical differences exist among essential, familial and senile tremor, or between the tremor with synchronous or alternating electromyographic activity. The aim of this study was to evaluate the clinical and electromyographic findings in a large group of patients with different types of essential tremor.

Methods:

Two hundred and twenty patients with sporadic, familial or senile variants of essential tremor were examined. According to the electromyographic activity recorded from the antagonistic muscles, the patients were subdivided into a group with synchronous (SYN) and a group with alternating (ALT) activity. The historical aspects of the disease were noted, and a detailed neurological examination was performed.

Results:

A widespread tremor involving upper and lower limbs and 3-4 different anatomical regions was typical for familial tremor. It also had higher amplitude than the sporadic and senile tremor. ALT tremor had a higher amplitude and longer burst duration than SYN and more often involved lower limbs. Rest tremor was common in the ALT group. Overall, ALT tremor was more common than previously supposed.

Conclusion:

The familial and ALT tremors are more disabling than other types of essential tremor. Since electromyographic ALT activity is common in essential tremor, its presence does not reliably distinguish essential and Parkinsonian tremor.

Résumé:

RÉSUMÉ:Introduction:

On croit généralement qu'il n'existe pas de différences cliniques entre le tremblement essentiel, familial ou sénile ainsi qu'entre le tremblement avec activité synchrone ou alternante à l'électromyographie. Le but de cette étude était de réévaluer les observations cliniques et électromyographiques d'un groupe de patients ayant différents types de tremblement essentiel.

Méthodes:

Deux cent vingt patients présentant un tremblement essentiel sporadique, familial ou sénile ont été examinés. Selon l'activité électromyographique enregistrée au niveau de muscles antagonistes, les patients ont été subdivisés en deux groupes: ceux avec activité synchrone (SYN) et ceux avec activité alternante (ALT). Les aspects historiques de la maladie ont été notés et les patients ont subi un examen neurologique détaillé.

Résultats:

Le tremblement généralisé impliquant les membres supérieurs et inférieurs et 3 ou 4 régions anatomiques différentes était typique du tremblement familial. Ce tremblement avait également une plus grande amplitude que le tremblement sporadique et le tremblement sénile. Le tremblement avec ALT avait une plus grande amplitude et des accès de tremblement plus longs que le tremblement SYN. Il impliquait plus souvent les membres inférieurs et un tremblement de repos était souvent présent. Le tremblement ALT était plus fréquent qu'on ne le pensait antérieurement.

Conclusion:

Les tremblements familial et ALT sont plus invalidants que les autres types de tremblement essentiel. L'activité alternante qu'on retrouve fréquemment soulève la question de l'utilité de l'ÉMG pour différencier le tremblement essentiel du tremblement parkinsonien.

Type
Original Article
Information
Canadian Journal of Neurological Sciences , Volume 27 , Issue 1 , February 2000 , pp. 65 - 70
Copyright
Copyright © The Canadian Journal of Neurological 2000

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