Louis Elan D
Department of Neurology, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Peter O'Donnell Jr. Brain Institute, University of Texas Southwestern Medical Center, Dallas, Texas, USA.
Mov Disord Clin Pract. 2025 Jan;12(1):57-65. doi: 10.1002/mdc3.14271. Epub 2024 Nov 8.
There are few published data on the prevalence, pattern of anatomic distribution and predictors of various cranial tremors (eg, head, voice, jaw) in essential tremor (ET). Given the high levels of diagnostic misclassification in ET, data on observed clinical patterns would be valuable.
To assess the prevalence, pattern of anatomic distribution and predictors of occurrence of cranial tremors in ET.
ET cases who enrolled in two studies (respective n's = 301 and 175, total n = 476) underwent a detailed clinical assessment, which included a videotaped neurological examination. A senior movement disorders neurologist reviewed the examination and coded a range of cranial tremors as present or absent.
The proportion of cases with any cranial tremor was 57.1% (Study 1) and 73.7% (Study 2). The following patterns emerged: (1) Head only and head + voice were the most commonly observed anatomical distribution of tremor. (2) Jaw tremors were rare, and face and tongue tremors, exceedingly rare. (3) There was a general layering-on of tremor from head to head + voice to head + voice + jaw in more advanced cases. (4) Women were more likely to have head tremors than men, although there was no sex predilection tremor in other locations. (5) The likelihood of cranial tremor increased with greater tremor severity and age but was unrelated to tremor duration.
We observed and quantified several patterns in the expression of cranial tremors in ET. Data on such patterns may assist clinicians and researchers in assigning diagnoses.
关于特发性震颤（ET）中各种颅部震颤（如头部、声音、下颌）的患病率、解剖分布模式及预测因素，发表的数据较少。鉴于ET的诊断错误分类率较高，有关观察到的临床模式的数据将很有价值。
评估ET中颅部震颤的患病率、解剖分布模式及发生的预测因素。
纳入两项研究的ET病例（分别为n = 301和175，总计n = 476）接受了详细的临床评估，其中包括录像神经学检查。一位资深运动障碍神经科医生对检查进行了回顾，并将一系列颅部震颤编码为存在或不存在。
有任何颅部震颤的病例比例在研究1中为57.1%，在研究2中为73.7%。出现了以下模式：（1）仅头部震颤和头部+声音震颤是最常见的震颤解剖分布。（2）下颌震颤罕见，面部和舌部震颤极其罕见。（3）在病情更严重的病例中，震颤通常从头部逐渐叠加到头部+声音再到头部+声音+下颌。（4）女性比男性更易出现头部震颤，尽管在其他部位没有性别偏好性震颤。（5）颅部震颤的可能性随震颤严重程度和年龄增加而增加，但与震颤持续时间无关。
我们观察并量化了ET中颅部震颤表现的几种模式。关于这些模式的数据可能有助于临床医生和研究人员进行诊断。
