DOCSLIB.ORG

What the Experts Say

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
What the Experts Say 1 Essential Tremor: What the Experts Say Collected Articles and Guidance Third Edition International Essential Tremor Foundation PO Box 14005, Lenexa, KS 66285-4005 888-387-3667 | 913-341-3880 (local) www.EssentialTremor.org |TremorTalk.org (blog) Facebook.com/InternationalEssentialTremorFoundation |Twitter.com/EssentialTremor Search “International Essential Tremor Foundation on YouTube and Google+ ©2014 IETF 2 Preface The International Essential Tremor Foundation (IETF) is pleased to publish this collection of informative articles about essential tremor (ET) written by some of the world’s finest movement disorders specialists and experts in related health care fields. Now in its third edition, this comprehensive book is an invaluable resource to assist with understanding essential tremor. We are confident that this collection will help to enrich your life by offering you educational material that can be referenced again and again. The IETF thanks the many physicians, health care providers, and other individuals that contributed time and effort to make these articles possible. These people have contributed greatly to the success of the IETF over the years. 3 About The International Essential Tremor Foundation (IETF) Founded in 1988 as a 501(c) (3) non-profit organization, the IETF is guided by an executive board of directors, a medical advisory board and an executive director with a staff of three. The organization's membership consists of patients, physicians, educators, health care workers, parents, relatives, friends and volunteers. Our Mission The IETF funds research to find the cause of essential tremor (ET) that leads to treatments and a cure, increases awareness, and provides educational materials, tools, and support for healthcare providers, the public, and those affected by ET. IETF Board of Directors Kelly Lyons, Ph.D., President Peter LeWitt, M.D., Vice President Russ Rosen, M.S.W., Secretary/Treasurer Edward M. Block, Ph.D., Secretary Shari Finsilver, Past President IETF Medical Advisory Board Mark Hallett, M.D., Chair Julian Benito-Leon, M.D., Ph.D.; Kelvin Chou, M.D.; Arif Dalvi, M.D.; Leon S. Dure, IV, M.D.; Rodger Elble, M.D., Ph.D.; W. Jeffrey Elias, M.D.; Leslie J. Findley, T.D., M.D., F.R.C.P.(C); Cole Giller, M.D.; Adrian Handforth, M.D.; Dietrich Haubenberger, M.D.; Peter Hedera, M.D.; Arif Dawood Herekar, M.D.; Joseph Jankovic, M.D.; Michael M. Johns III, M.D.; Amos D. Korczyn, M.D., M.Sc.; Anthony E. Lang, M.D., F.R.C.P.(C); Peter LeWitt, M.D.; Elan D. Louis, M.D.., M.Sc.; Fatta Nahab, M.D.; William Ondo, M.D.; Jill L. Ostrem, M.D.; Alexander Rajput, M.D., F.R.C.P.(C); Ali H. Rajput, M.D., F.R.C.P.(C); Arshia Sadreddin, M.D.; Sara Salles, D.O.; Ludy Shih, M.D.; Holly Shill, M.D.; Mark Stacy, M.D.; Claudia Testa M.D., Ph.D.; Jay Van Gerpen, M.D.; Theresa Zesiewicz, M.D., F.A.A.N. IETF Executive Director Catherine S. Rice, M.N.M 4 Table of Contents Glossary of Common ET Terms ............................................................................................... 8 Glossary of ET Terms ........................................................................................................................................................................ 9 What Is Essential Tremor? ...................................................................................................... 14 The History of Tremor .................................................................................................................................................................... 15 Toward a Definition of ET ............................................................................................................................................................. 17 The Natural History of ET .............................................................................................................................................................. 20 The Pathology of ET ........................................................................................................................................................................ 21 ET Fact Sheet .................................................................................................................................................................................... 22 Types of Tremor ............................................................................................................................................................................... 23 Who Gets Essential Tremor? ................................................................................................... 25 Genetic Concepts and ET ............................................................................................................................................................... 26 Genetics of ET .................................................................................................................................................................................. 28 Epidemiology of ET: An Update ................................................................................................................................................... 29 Prevalence of ET ............................................................................................................................................................................... 32 Gender Differences in Tremor ....................................................................................................................................................... 34 Can a Child Have ET? ...................................................................................................................................................................... 35 Getting the Diagnosis .............................................................................................................. 36 Tremor Analysis ................................................................................................................................................................................ 37 Examination of the Patient with Tremor...................................................................................................................................... 39 Methods of Assessing Tremor in Clinical Trials and in Everyday Clinical Practice ............................................................. 40 Is Everything that Trembles Parkinson’s Disease? ..................................................................................................................... 42 ET vs Parkinson’s disease: How do they differ? ......................................................................................................................... 45 Misdiagnosis and its Ramifications ................................................................................................................................................ 47 Three Steps to Choosing a Doctor ................................................................................................................................................ 48 Second Opinions: Knowing Your Rights and Options ............................................................................................................. 49 Life with Essential Tremor ...................................................................................................... 51 Addressing the Psychological Aspects of Essential Tremor ET’s Impact on Emotional and Mental Processes ............ 52 Psychosocial Aspects of Tremor .................................................................................................................................................... 54 Emotional Aspects of ET ................................................................................................................................................................ 55 ET, Depression, and Anxiety .......................................................................................................................................................... 57 Tremor and Stress ............................................................................................................................................................................. 58 Stress and ET ..................................................................................................................................................................................... 59 Functional Disability with ET ......................................................................................................................................................... 60 ET and Aging ..................................................................................................................................................................................... 61 5 ET and Pregnancy ............................................................................................................................................................................. 62 Treatment Options .................................................................................................................. 64 Medications Commonly Prescribed for ET ................................................................................................................................. 65 Topiramate and ET........................................................................................................................................................................... 67 Adverse
Load more

Recommended publications
  • Comorbid Neuropathologies in Migraine Luigi Olivieri Stefano Bastianello Antonio Carolei
    View metadata, citation and similar papers at core.ac.uk brought to you by CORE provided by Springer - Publisher Connector J Headache Pain (2006) 7:222–230 DOI 10.1007/s10194-006-0300-8 TUTORIAL Simona Sacco Comorbid neuropathologies in migraine Luigi Olivieri Stefano Bastianello Antonio Carolei Received: 20 April 2006 Abstract The identification of cause, and migraine associated Accepted in revised form: 16 May 2006 comorbid disorders in migraineurs with subclinical vascular brain Published online: 15 June 2006 is important since it may impose lesions. therapeutic challenges and limit treatment options. Moreover, the study of comorbidity might lead to improve our knowledge about S. Sacco • L. Olivieri • A. Carolei Department of Neurology, causes and consequences of University of L’Aquila, migraine. Comorbid neuropatholo- 67100 L’Aquila, Italy gies in migraine may involve mood disorders (depression, S. Bastianello IRCCS C. Mondino mania, anxiety, panic attacks), Pavia, Italy epilepsy, essential tremor, stroke, and white matter abnormalities. A. Carolei (౧) Particularly, a complex bidirection- Neurologic Clinic, al relation exists between migraine Department of Internal Medicine and stroke, including migraine as a and Public Health, risk factor for cerebral ischemia, University of L’Aquila, migraine caused by cerebral Piazzale Salvatore Tommasi 1, I-67100 L’Aquila-Coppito, Italia ischemia, migraine as a cause of Key words Migraine • Depression • e-mail: [email protected] stroke, migraine mimicking cere- Epilepsy • Tremor • Stroke • White
    [Show full text]
  • National Center for Toxicological Research
    National Center for Toxicological Research Annual Report Research Accomplishments and Plans FY 2015 – FY 2016 Page 0 of 193 Table of Contents Preface – William Slikker, Jr., Ph.D. ................................................................................... 3 NCTR Vision ......................................................................................................................... 7 NCTR Mission ...................................................................................................................... 7 NCTR Strategic Plan ............................................................................................................ 7 NCTR Organizational Structure .......................................................................................... 8 NCTR Location and Facilities .............................................................................................. 9 NCTR Advances Research Through Outreach and Collaboration ................................... 10 NCTR Global Outreach and Training Activities ............................................................... 12 Global Summit on Regulatory Science .................................................................................................12 Training Activities .................................................................................................................................14 NCTR Scientists – Leaders in the Research Community .................................................. 15 Science Advisory Board ...................................................................................................
    [Show full text]
  • Inflated Praise Leads Socially Anxious Children to Blush
    UvA-DARE (Digital Academic Repository) When gushing leads to blushing: Inflated praise leads socially anxious children to blush Nikolić , M.; Brummelman, E.; Colonnesi, C.; de Vente, W.; Bögels, S.M. DOI 10.1016/j.brat.2018.04.003 Publication date 2018 Document Version Final published version Published in Behaviour Research and Therapy Link to publication Citation for published version (APA): Nikolić , M., Brummelman, E., Colonnesi, C., de Vente, W., & Bögels, S. M. (2018). When gushing leads to blushing: Inflated praise leads socially anxious children to blush. Behaviour Research and Therapy, 106, 1-7. https://doi.org/10.1016/j.brat.2018.04.003 General rights It is not permitted to download or to forward/distribute the text or part of it without the consent of the author(s) and/or copyright holder(s), other than for strictly personal, individual use, unless the work is under an open content license (like Creative Commons). Disclaimer/Complaints regulations If you believe that digital publication of certain material infringes any of your rights or (privacy) interests, please let the Library know, stating your reasons. In case of a legitimate complaint, the Library will make the material inaccessible and/or remove it from the website. Please Ask the Library: https://uba.uva.nl/en/contact, or a letter to: Library of the University of Amsterdam, Secretariat, Singel 425, 1012 WP Amsterdam, The Netherlands. You will be contacted as soon as possible. UvA-DARE is a service provided by the library of the University of Amsterdam (https://dare.uva.nl) Download date:24 Sep 2021 Behaviour Research and Therapy 106 (2018) 1–7 Contents lists available at ScienceDirect Behaviour Research and Therapy journal homepage: www.elsevier.com/locate/brat When gushing leads to blushing: Inflated praise leads socially anxious T children to blush ∗ Milica Nikolića, , Eddie Brummelmana,b, Cristina Colonnesia, Wieke de Ventea, Susan M.
    [Show full text]
  • Vet Oracle Teleneurology: Client Factsheet
    Client Factsheet Paroxysmal Dyskinesia Paroxysmal Dyskinesia: A little bit of background Paroxysmal dyskinesias (PDs) are episodic movement disorders in which abnormal movements are present only during attacks. Although increasingly being recognised, they are often poorly characterised in veterinary literature and are commonly mistaken for an epileptic seizure, both by owners and by vets. The term ‘paroxysmal’ indicates that the signs occur suddenly against a background of normality. The term ‘dyskinesia’ broadly refers to a movement of the body that is involuntary, which means that the animal has no control over the movement and remains fully aware of its surroundings. Between attacks, affected animals are totally normal and there is no loss of consciousness during the attacks, though some animals may find the episodes disconcerting and do not respond normally. The attacks can last anything from a few minutes to a couple of hours and can sometime occur multiple times in a day. What causes Paroxysmal Dyskinesia? Most neurologists consider that PD results from dysfunction an area of the brain called the basal nuclei (often call the basal ganglia) and the cerebellum which is a fundamental part of the brain that involves in coordinating movement. Nerve cells in the basal nuclei play an important role in initiating and controlling movement. It is thought that abnormal signal from the cerebellum causes abnormal activity of the basal nuclei, which results in spontaneous and uncontrolled muscle activity and, therefore, movement and posture. The underlying cause of many PDs is unknown, with the majority being described as idiopathic (meaning of unknown cause) and presumed to be related to abnormal brain signalling between different parts involved with movement or its feedback control.
    [Show full text]
  • TAAR1 Activation Modulates Monoaminergic Neurotransmission, Preventing Hyperdopaminergic and Hypoglutamatergic Activity
    TAAR1 activation modulates monoaminergic neurotransmission, preventing hyperdopaminergic and hypoglutamatergic activity Florent G. Revela, Jean-Luc Moreaua, Raul R. Gainetdinovb, Amyaouch Bradaiac, Tatyana D. Sotnikovab, Roland Morya, Sean Durkina, Katrin Groebke Zbindend, Roger Norcrossd, Claas A. Meyere, Veit Metzlera, Sylvie Chaboza, Laurence Ozmena, Gerhard Trubea, Bruno Pouzeta, Bernhard Bettlerf, Marc G. Carong, Joseph G. Wettsteina, and Marius C. Hoenera,1 aNeuroscience Research, dDiscovery Chemistry, and eDiscovery Technologies, Pharmaceuticals Division, F. Hoffmann-La Roche Ltd., CH-4070 Basel, Switzerland; bDepartment of Neuroscience and Brain Technologies, Italian Institute of Technology, 16163 Genoa, Italy; cNeuroservice, Domaine de Saint-Hilaire, 13593 Aix-en-Provence, France; fDepartment of Biomedicine, Institute of Physiology, Pharmazentrum, University of Basel, CH-4056 Basel, Switzerland; and gDepartment of Cell Biology, Duke University Medical Center, Durham, NC 27710 Edited by Richard D. Palmiter, University of Washington, Seattle, WA, and approved March 31, 2011 (received for review February 24, 2011) The trace amine-associated receptor 1 (TAAR1), activated by en- sitive to the locomotor-stimulating effect of d-amphetamine dogenous metabolites of amino acids like the trace amines and show elevated striatal release of dopamine (DA), noradren- p-tyramine and β-phenylethylamine, has proven to be an impor- aline (NA), and serotonin [5-hydroxytryptamine (5-HT)] after a d-amphetamine challenge (10, 12). Furthermore, the spontaneous tant modulator of the dopaminergic system and is considered −/− firing rate of the VTA DA neurons is augmented in Taar1 mice, a promising target for the treatment of neuropsychiatric disorders. fi To decipher the brain functions of TAAR1, a selective TAAR1 ago- and only in WT mice does pTyr decrease this ring rate (10).
    [Show full text]
  • THE MANAGEMENT of TREMOR Peter G Bain
    J Neurol Neurosurg Psychiatry: first published as 10.1136/jnnp.72.suppl_1.i3 on 1 March 2002. Downloaded from THE MANAGEMENT OF TREMOR Peter G Bain *i3 J Neurol Neurosurg Psychiatry 2002;72(Suppl I):i3–i9 remor is defined as a rhythmical, involuntary oscillatory movement of a body part.1 The Tformulation of a clinical diagnosis for an individual’s tremor involves two discrete steps2: c The observed tremor is classified on phenomenological grounds c An attempt is made to find the cause of the tremor by looking for aetiological clues in the patient’s history and physical examination and also, in some cases, by investigation. c PHENOMENOLOGICAL CLASSIFICATION OF TREMOR The phenomenological classification of tremor is determined by finding out: c which parts of the patient’s body are affected by tremor? c what types (or components) of tremor, classified by state of activity, are present at those anatomical sites? The following definitions are used to describe the various tremor components evident on exam- ination1: c Rest tremor is a tremor present in a body part that is not voluntarily activated and is completely supported against gravity (ideally resting on a couch) copyright. c Action tremor is any tremor that is produced by voluntary contraction of a muscle. It includes pos- tural, kinetic, intention, task specific, and isometric tremor: – Postural tremor is present while voluntarily maintaining a position against gravity – Kinetic tremor is tremor occurring during any voluntary movement. Simple kinetic tremor occurs during voluntary movements that are not target directed – Intention tremor or tremor during target directed movement is present when tremor amplitude increases during visually guided movements towards a target at the termination of that movement, when the possibility of position specific tremor or postural tremor produced at the beginning and end of a movement has been excluded – Task specific kinetic tremor—kinetic tremor may appear or become exacerbated during specific activities.
    [Show full text]
  • Clinical Challenge (Pdf 204KB)
    EDUCATION CLINICALCHALLenGE Questions for this month’s clinical challenge are based on articles in this issue. The style and scope of questions is in keeping with the MCQ of the College Fellowship exam. The quiz is endorsed by the RACGP Quality Assurance and Continuing Professional Development Program and has been allocated 4 CPD points per issue. Answers to this clinical challenge will be published next month, and are available immediately following successful completion online at www.racgp.org.au/clinicalchallenge. Check clinical challenge online for this month's completion date. Rachel Lee DIRECTIONS Each of the questions or incomplete statements below is followed by five suggested answers or completions. Select the most appropriate statement as your answer. Case 1 – Phillip Block Case 2 – the Babic family Phillip Block, 19 years of age, is a football player who presents The Babic family come to see you as they all have persistent sore embarrassed about his sweaty, smelly feet. feet. Question 1 Question 5 You consider a diagnosis of primary palmoplantar Elena, 11 years of age, has heel pain exacerbated by activity. hyperhidrosis. Which of the following statements is a common Select the best statement about her pain: diagnostic criteria: A. calcaneal traction apophysitis is likely and should soon A. asymmetrical presentation – dominant side usually more resolve with apophysial closure affected B. the possibility of osteochrondrosis can be confidently B. persistence of sweating even during sleep excluded by plain X-ray C. persistence of sweating beyond 6 months C. an ‘accessory navicular’ is unlikely as this is typically worse D. onset typically after the age of 25 years at rest E.
    [Show full text]
  • Myelopathy—Paresis and Paralysis in Cats
    Myelopathy—Paresis and Paralysis in Cats (Disorder of the Spinal Cord Leading to Weakness and Paralysis in Cats) Basics OVERVIEW • “Myelopathy”—any disorder or disease affecting the spinal cord; a myelopathy can cause weakness or partial paralysis (known as “paresis”) or complete loss of voluntary movements (known as “paralysis”) • Paresis or paralysis may affect all four limbs (known as “tetraparesis” or “tetraplegia,” respectively), may affect only the rear legs (known as “paraparesis” or “paraplegia,” respectively), the front and rear leg on the same side (known as “hemiparesis” or “hemiplegia,” respectively) or only one limb (known as “monoparesis” or “monoplegia,” respectively) • Paresis and paralysis also can be caused by disorders of the nerves and/or muscles to the legs (known as “peripheral neuromuscular disorders”) • The spine is composed of multiple bones with disks (intervertebral disks) located in between adjacent bones (vertebrae); the disks act as shock absorbers and allow movement of the spine; the vertebrae are named according to their location—cervical vertebrae are located in the neck and are numbered as cervical vertebrae one through seven or C1–C7; thoracic vertebrae are located from the area of the shoulders to the end of the ribs and are numbered as thoracic vertebrae one through thirteen or T1–T13; lumbar vertebrae start at the end of the ribs and continue to the pelvis and are numbered as lumbar vertebrae one through seven or L1–L7; the remaining vertebrae are the sacral and coccygeal (tail) vertebrae • The brain
    [Show full text]
  • Movement Disorders Program & the Murray Center for Research on Parkinson's Disease & Related Disorders
    Movement Disorders Medical University of South Carolina MUSC Health Movement DisordersMovement Disorders Program Program Program & The Murray 96 Jonathan Lucas Street, and the Murray Center for Research on Parkinson’sSuite Disease 301 CSB, MSC and 606 Related Disorders Center for Research on Charleston, SC 29425 Parkinson’s Disease & Related Disorders muschealth.org 843-792-3221 Changing What’s Possible “Our focus is providing patients with the best care possible, from treatment options to the latest technology and research. We have an amazing team of experts that provides compassionate care to each individual that we see.” — Dr. Vanessa Hinson Getting help from the MUSC Health Movement Disorders Program Millions of Americans suffer from movement disorders. These are typically characterized by involuntary movements, shaking, slowness of movement, or uncontrollable muscle contractions. As a result, day to day activities like walking, dressing, dining, or writing can become challenging. The MUSC Health Movement Disorders Program offers a comprehensive range of services, from diagnostic testing and innovative treatments to rehabilitation and follow-up support. Our team understands that Parkinson’s disease and other movement disorders can significantly impact quality of life. Our goal is to provide you and your family continuity of care with empathy and compassion throughout the treatment experience. Please use this guide to learn more about Diseases Treated – information about the disorders and symptoms you might feel Specialty Procedures – treatments that show significant improvement for many patients Research – opportunities to participate in clinical trials at the MUSC Health Movement Disorders Program Profiles – MUSC Health movement disorder specialists We are dedicated to finding the cure for disabling movement disorders and to help bring about new treatments that can improve our patients’ lives.
    [Show full text]
  • 'Gating' Residues Ile199 and Tyr326 in Human Monoamine Oxidase B
    The ‘gating’ residues Ile199 and Tyr326 in human monoamine oxidase B function in substrate and inhibitor recognition Erika M. Milczek1,*, Claudia Binda2, Stefano Rovida2, Andrea Mattevi2 and Dale E. Edmondson1 1 Departments of Chemistry and Biochemistry, Emory University, Atlanta, Georgia, USA 2 Department of Genetics and Microbiology, University of Pavia, Italy Keywords The major structural difference between human monoamine oxidases A dipartite to monopartite cavity conversion; (MAO A) and B (MAO B) is that MAO A has a monopartite substrate inhibitor specificity; monoamine oxidase B; cavity of 550 A˚3 volume and MAO B contains a dipartite cavity struc- mutations of gating residues; structure of ture with volumes of 290 A˚3 (entrance cavity) and 400 A˚3 (substrate methylene blue complex cavity). Ile199 and Tyr326 side chains separate these two cavities in MAO Correspondence B. To probe the function of these gating residues, Ile199Ala and Ile199Ala- D. E. Edmondson, Department of Tyr326Ala mutant forms of MAO B were investigated. Structural data on Biochemistry, Emory University, 1510 the Ile199Ala MAO B mutant show no alterations in active site geometries Clifton Road, Atlanta, GA 30322, USA compared with wild-type enzyme while the Ile199Ala-Tyr326Ala MAO B Fax: +1 404 727 2738 mutant exhibits alterations in residues 100–103 which are part of the loop Tel: +1 404 727 5972 gating the entrance to the active site. Both mutant enzymes exhibit catalytic E-mail: [email protected] properties with increased amine KM but unaltered kcat values. The altered *Present address KM values on mutation are attributed to the influence of the cavity struc- Department of Chemistry, Princeton ture in the binding and subsequent deprotonation of the amine substrate.
    [Show full text]
  • Essential Tremor Patient Handbook
    Essential Tremor Patient Handbook Your reference guide for the most common movement disorder. What is essential tremor? Essential tremor (ET) is one of the most common neurological conditions and the most common cause of tremor. Tremor is an involuntary, rhyth- mic shaking of any part of the body. The hands are most commonly affected in ET, but the head, voice, legs, and trunk can also be affected. The term essential, when used in a medical context, refers to a symptom that is isolated and does not have a specific underlying cause. Thus, ET refers to a disorder that displays the primary symptom of tremor, with no known cause. The tremor of ET is an action tremor and most commonly occurs while performing activities such as eating, drinking, writing, typing, brushing teeth, shaving, etc. (kinetic tremor) or when the hands are in an outstretched position (postural tremor). ET can therefore make it difficult to complete ev- eryday tasks and can lead to significant disability. Some patients may present with a combination of tremors affecting different body parts. The sever- ity of the tremor can vary from a barely notice- able tremor only present in situations of stress or anxiety, to severe tremor that has a significant impact on activities of daily living. Tremor severity can vary based on the activity being performed, the position of the body part, and the presence of stress or fatigue. The tremor may worsen over time and may spread to parts of the body not pre- viously affected. Who develops ET? ET is estimated to affect up to 10 million people in the United States and many more worldwide.
    [Show full text]
  • Clinical Decision Making in Neurology
    CLINICAL DECISION MAKING IN NEUROLOGY The Neurological Examination The goals of the neurological examination are to detect the presence of a neurologic disease and to determine the location of the lesion within the nervous system. The neurologic examination should be performed in a systematic manner in order to assure that the animal's neurologic status is completely evaluated. The parts of a customary neurologic examination include evaluation of the head (mentation and cranial nerves), gait, limbs (postural reactions and spinal reflexes) and pain/nociception (normal and abnormal pain responses). Gait Evaluation I find gait evaluation the most useful and important part of the neurologic exam. Clinical evaluation of gait usually involves observation of the animal's movements while walking. This is best accomplished by having a handler walk the animal over a flat, non-slippery area. I typically evaluate gait by having a handler walk the animal approximately 100 feet, away and back, as well as circling clockwise and counterclockwise. I have the animal short on the leash and under good control and have the dog typically walk slowly. I may have them walk on and off the curb. Overall, evaluation is made by watching for paresis, ataxia, stride length, lameness, stiffness, spasticity, dysmetria and shuffling or scuffing of limbs or digits. I also note position of head and tail during gait evaluation. Gait analysis is broken down between the axial and appendicular skeleton. The axial vertebral column is made up of many joints and is divided into anatomical segments. The axial portion includes the head, neck, thoracic, lumbar, lumbar/pelvic and tail.
    [Show full text]