Pandey Sanjay, Sarma Neelav
Department of Neurology Govind Ballabh Pant Postgraduate Institute of Medical Education and Research New Delhi India.
Mov Disord Clin Pract. 2017 Oct 3;4(6):858-863. doi: 10.1002/mdc3.12546. eCollection 2017 Nov-Dec.
Tremor is an important phenotypic motor feature in dystonia, but there is limited literature regarding its prevalence and phenomenology.
This cross-sectional study included 90 patients with adult-onset, isolated dystonia from a tertiary care movement disorder center in India. Patients were assessed for tremor in the head and in different body parts. Surface electromyography studies of tremor were recorded of the involved limb in different positions.
Tremor was present in 41 patients (45.55%) who had dystonia, including 21 of 41 patients (51.21%) with cervical dystonia, 15 of 34 (44.11%) with limb dystonia, and 5 of 15 (33.33%) with cranial dystonia. Significantly later age at presentation (47.19 ± 14.55 years vs. 40.39 ± 13.74 years; = 0.012) and longer disease duration (5.11 ± 5.85 years vs. 2.60 ± 2.57 years; = 0.004) were observed in patients with versus without tremor. Upper limb tremor was present in 33 patients, head tremor was present in 14, and leg tremor was present in 2. Tremor was present in 17 of 25 patients (68%) with segmental dystonia and in 6 of 9 (66.66%) with multifocal dystonia. Tremor was least frequent in patients with focal dystonia (18 of 56 patients; 32.14%).
Tremor was common (>45%) in patients with primary adult-onset dystonia. Patients who had tremor were older and had a longer duration of symptoms. Patients with segmental and multifocal dystonia had more tremor than those with focal dystonia. In contrast to some other studies, the current patients had more upper limb tremor than head tremor, and a combination of dystonic tremor and tremor associated with dystonia was more common than isolated dystonic tremor.
震颤是肌张力障碍的一个重要表型运动特征，但关于其患病率和现象学的文献有限。
这项横断面研究纳入了来自印度一家三级医疗运动障碍中心的90例成年起病的孤立性肌张力障碍患者。对患者的头部和不同身体部位进行震颤评估。在不同体位下，对受累肢体进行震颤的表面肌电图研究记录。
41例（45.55%）肌张力障碍患者存在震颤，其中41例颈肌张力障碍患者中有21例（51.21%）、34例肢体肌张力障碍患者中有15例（44.11%）、15例颅肌张力障碍患者中有5例（33.33%）存在震颤。有震颤与无震颤的患者相比，出现症状时的年龄显著更大（47.19±14.55岁 vs. 40.39±13.74岁；P = 0.012），病程更长（5.11±5.85年 vs. 2.60±2.57年；P = 0.004）。33例患者存在上肢震颤，14例存在头部震颤，2例存在腿部震颤。25例节段性肌张力障碍患者中有17例（68%）存在震颤，9例多灶性肌张力障碍患者中有6例（66.66%）存在震颤。局灶性肌张力障碍患者中震颤最少见（56例患者中有18例；32.14%）。
原发性成年起病的肌张力障碍患者中震颤很常见（>45%）。有震颤的患者年龄更大，症状持续时间更长。节段性和多灶性肌张力障碍患者比局灶性肌张力障碍患者有更多震颤。与其他一些研究不同的是，当前这些患者上肢震颤比头部震颤更多见，肌张力障碍性震颤和与肌张力障碍相关的震颤并存比孤立的肌张力障碍性震颤更常见。
