Kestenbaum Meir, Michalec Monika, Yu Qiping, Pullman Seth L, Louis Elan D
Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
GH Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
Mov Disord Clin Pract. 2015 Mar 1;2(1):24-28. doi: 10.1002/mdc3.12099.
To estimate the prevalence and assess the clinical correlates of intention tremor in the legs in essential tremor (ET) patients.
The cerebellar features of ET are of growing interest to clinical neurologists. Arm tremor has an intentional component in many ET patients. Intention tremor in the legs, however, has never been systematically evaluated.
One-hundred-twenty-eight ET patients were enrolled in a clinical-epidemiological study at Columbia University. A videotaped neurological examination included 10 toe-to-target movements with each foot. Videotapes were independently reviewed by two movement disorder neurologists who noted the presence vs. absence of intentional leg tremor. Two patients underwent quantitative computerized tremor analysis to study the physiological characteristics of the tremor.
Thirty-five patients (27.3%) had intentional leg tremor; in 21, tremor was unilateral and in 14 it was bilateral. The 35 patients with intentional leg tremor did not differ from the remaining 93 patients in their clinical characteristics. Analyses comparing the 14 patients with bilateral intentional leg tremor to the 93 patients with no intentional leg tremor showed trends towards longer disease duration and more severe intentional arm tremor in the former. Tremor analysis showed a 3-fold increase in average tremor amplitude from movement onset to the point just prior to touching the target.
Our data suggest that intentional leg tremor, another cerebellar feature, is common in ET patients. The tremor may be associated with longer disease duration and more severe intentional arm tremor, but these preliminary trends need to be assessed in larger study samples.
评估特发性震颤（ET）患者腿部意向性震颤的患病率，并分析其临床相关因素。
ET的小脑特征越来越受到临床神经科医生的关注。许多ET患者的手臂震颤存在意向性成分。然而，腿部的意向性震颤从未得到系统评估。
128例ET患者参加了哥伦比亚大学的一项临床流行病学研究。录像神经学检查包括每只脚进行10次从脚趾到目标的动作。两名运动障碍神经科医生独立查看录像带，记录是否存在腿部意向性震颤。两名患者接受了定量计算机震颤分析，以研究震颤的生理特征。
35例患者（27.3%）存在腿部意向性震颤；其中21例为单侧震颤，14例为双侧震颤。35例有腿部意向性震颤的患者与其余93例患者在临床特征上无差异。将14例双侧腿部意向性震颤患者与93例无腿部意向性震颤患者进行比较分析，结果显示前者病程更长、手臂意向性震颤更严重。震颤分析显示，从动作开始到即将触及目标时，平均震颤幅度增加了3倍。
我们的数据表明，作为ET另一个小脑特征的腿部意向性震颤在ET患者中很常见。这种震颤可能与病程较长和手臂意向性震颤更严重有关，但这些初步趋势需要在更大的研究样本中进行评估。
