"In addition to idiopathic cases , slow OT has been associated with familial essential tremor , multiple sclerosis , Parkinson's disease and parkinsonism . OT has been associated with Graves disease , thiamine deficiency , monoclonal and biclonal gammopathy of underdetermined significance  , and small cell cancer lung cancer with positive anti-Hu antibodies . Other unusual associations include delayed onset OT after head trauma , a nonenhancing structural lesion in the left dorsolateral midbrain  and lesions (schwannoma and tuberculoma) affecting the pontine structures . "
[Show abstract][Hide abstract] ABSTRACT: Objective
To evaluate the clinical characteristics, associated features, and treatment response of a large orthostatic tremor series seen over a 26-year period.
We reviewed the medical records of 45 patients seen between 1987 and 2013 who fulfilled the diagnostic criteria for orthostatic tremor.
The mean age at onset was 59.5 years and 23/45 (51%) were men. A family history of any tremor was noted in 23/45 (51%) patients. A family history of orthostatic tremor was reported in 3/45 (7%) patients. 40/45 (89%) had primary orthostatic tremor with (n=30) or without (n=10) an associated postural arm tremor. We found that 5/45 (11%) had orthostatic tremor plus additional neurological features. One patient was diagnosed with dementia with Lewy bodies preceded by orthostatic tremor for 20 years. Prospective follow-up data was available for 30/45 patients and averaged 54.4 months. Treatment response to medications was modest and inconsistent. In 11/30 cases, orthostatic tremor worsened over the follow-up period. One patient with primary orthostatic tremor underwent thalamic deep brain stimulation surgery.
In our population of orthostatic tremor patients, mild postural hand tremor was a frequent finding. Over half of our patients had a family history of tremor, but a family history of orthostatic tremor was uncommon. Additional neurological features were seen in the minority of patients and we report possibly the first case of dementia with Lewy bodies associated with orthostatic tremor. Our series is the largest series of orthostatic tremor reported in the literature and contributes to understanding the clinical characteristics of this rare disease.
[Show abstract][Hide abstract] ABSTRACT: Tremor represents one of the most common movement disorders worldwide. It affects both sexes and may occur at any age. In most cases, tremor is disabling and causes social difficulties, resulting in poorer quality of life. Tremor is now recognized as a public health issue given the ageing of the population. Tremor is a complex phenomenon that has attracted the attention of scientists from various disciplines. Tremor results from dynamic interactions between multiple synaptically coupled neuronal systems and the biomechanical, physical, and electrical properties of the external effectors. There have been major advances in our understanding of tremor pathogenesis these last three decades, thanks to new imaging techniques and genetic discoveries. Moreover, significant progress in computer technologies, developments of reliable and unobtrusive wearable sensors, improvements in miniaturization, and advances in signal processing have opened new perspectives for the accurate characterization and daily monitoring of tremor. New therapies are emerging. In this book, we provide an overview of tremor from pathogenesis to therapeutic aspects. We review the definitions, the classification of the varieties of tremor, and the contribution of central versus peripheral mechanisms. Neuroanatomical, neurophysiological, neurochemical, and pharmacological topics related to tremor are pointed out. Our goals are to explain the fundamental basis of tremor generation, to show the recent technological developments, especially in instrumentation, which are reshaping research and clinical practice, and to provide up-to-date information related to emerging therapies. The integrative transdisciplinary approach has been used, combining engineering and physiological principles to diagnose, monitor, and treat tremor. Guidelines for evaluation of tremor are explained. This book has been written for biomedical engineering students, engineers, researchers, medical students, biologists, neurologists, and biomedical professionals of any discipline looking for an updated and multidisciplinary overview of tremor. It can be used for biomedical courses.
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