IRCCS Neuromed, Pozzilli (IS), Italy.
Department of Human Neurosciences, Sapienza University of Rome, Viale dell'Università, 30, 00185, Rome, Italy.
Cerebellum. 2021 Jun;20(3):374-383. doi: 10.1007/s12311-020-01216-5. Epub 2020 Nov 16.
Tremor is a common movement disorder that can be induced by medications, including valproate, which is used for the treatment of epilepsy. However, the clinical and neurophysiological features of valproate-induced tremor are still under-investigated. We performed a clinical and kinematic assessment of valproate-induced tremor by considering tremor body distribution and activation conditions. We investigated possible correlations between demographic and clinical data and kinematic features. Valproate-induced tremor results were also compared with those collected in a large sample of patients with essential tremor. Sixteen valproate-induced tremor patients and 93 essential tremor patients were enrolled. All participants underwent a standardised neurological examination and video recording. Patients also underwent an objective assessment of postural, kinetic and rest tremor of the upper limbs and head tremor through kinematic analysis. Nonparametric tests were used for statistical comparisons between the two groups. Clinical evaluation showed a higher occurrence of rest tremor as well as head or voice, and lower limb involvement in patients with valproate-induced tremor. Kinematic analysis showed a substantial variability in the tremor features of patients with valproate-induced tremor. Compared to essential tremor, we found a higher occurrence of rest tremor of the upper limbs and the involvement of more body segments in valproate-induced tremor patients. Valproate-induced tremor has distinctive clinical and kinematic features, which may suggest that valproate interferes with the cerebellar functions.
震颤是一种常见的运动障碍，可以由药物引起，包括丙戊酸钠，它被用于治疗癫痫。然而，丙戊酸钠引起的震颤的临床和神经生理学特征仍未得到充分研究。我们通过考虑震颤的身体分布和激活条件，对丙戊酸钠引起的震颤进行了临床和运动学评估。我们研究了人口统计学和临床数据与运动学特征之间的可能相关性。还将丙戊酸钠引起的震颤结果与从大量原发性震颤患者中收集的数据进行了比较。纳入了 16 名丙戊酸钠引起的震颤患者和 93 名原发性震颤患者。所有参与者都接受了标准的神经学检查和视频记录。患者还通过运动学分析对上肢和头部震颤的姿势、动力和静止震颤以及下肢震颤进行了客观评估。使用非参数检验对两组之间进行了统计比较。临床评估显示，丙戊酸钠引起的震颤患者更常出现静止震颤以及头部或声音震颤，下肢受累较少。运动学分析显示，丙戊酸钠引起的震颤患者的震颤特征存在很大的可变性。与原发性震颤相比，我们发现丙戊酸钠引起的震颤患者上肢静止震颤的发生率更高，受累的身体部位更多。丙戊酸钠引起的震颤具有独特的临床和运动学特征，这可能表明丙戊酸钠干扰了小脑功能。
