Rapoport A, Stein D, Shamir E, Schwartz M, Levine J, Elizur A, Weizman A
Department of Neurology, Wolfson Medical Center, Holon, Israel.
Int Clin Psychopharmacol. 1998 May;13(3):115-20. doi: 10.1097/00004850-199805000-00004.
Instrumental tremorgrams have been used to improve the diagnostic accuracy of various movement disorders, including tardive akathisia. The aim of the present work was to evaluate their place in the diagnosis of neuroleptic-induced tremor and to determine whether they can help to differentiate this disorder from other neuroleptic-induced movement disorders and from other types of tremor. Fourteen psychiatric patients treated with various neuroleptic medications were diagnosed as having neuroleptic-induced tremor on the basis of clinical criteria. They underwent accelerometric recordings following diagnosis. All patients demonstrated upper-limb tremor; four also had involvement of the lower limbs, jaw or tongue. Most demonstrated both resting and postural tremor, the latter being the more prominent. The tremor was mainly rhythmic, regular and sinusoidal. It did not significantly interfere with activities of daily living in the majority of patients, but four did exhibit some degree of impairment. Repeated accelerometric recordings showed constant and regular waveforms and frequencies (between 4 and 7 Hz) in each patient. We conclude that the presence of repeated constant waveforms and frequencies on accelerometric tracings may serve as confirmation of the diagnosis of neuroleptic-induced tremor. In light of the findings of this and other studies, we suggest that tremorgrams may be helpful in differentiating neuroleptic-induced tremor from other neuroleptic-induced movement disorders (e.g., tardive dyskinesia and tardive akathisia) and from psychogenic tremor. Although these techniques may also assist in the differentiation of neuroleptic-induced tremor from some tremor disorders (e.g., asterixis or ataxic tremor), their overall potential to distinguish it from other types of organic tremor is more limited.
仪器震颤图已被用于提高各种运动障碍（包括迟发性静坐不能）的诊断准确性。本研究的目的是评估它们在抗精神病药物所致震颤诊断中的地位，并确定它们是否有助于将这种疾病与其他抗精神病药物所致运动障碍以及其他类型的震颤区分开来。14名接受各种抗精神病药物治疗的精神病患者根据临床标准被诊断为患有抗精神病药物所致震颤。诊断后，他们接受了加速度测量记录。所有患者均表现出上肢震颤；4名患者还伴有下肢、下颌或舌头受累。大多数患者表现出静止性和姿势性震颤，后者更为明显。震颤主要为节律性、规则性和正弦性。在大多数患者中，震颤并未对日常生活活动造成明显干扰，但有4名患者确实表现出一定程度的功能损害。重复的加速度测量记录显示，每位患者的波形和频率（4至7赫兹之间）恒定且规则。我们得出结论，加速度测量描记图上重复出现的恒定波形和频率可作为抗精神病药物所致震颤诊断的依据。根据本研究及其他研究的结果，我们认为震颤图可能有助于将抗精神病药物所致震颤与其他抗精神病药物所致运动障碍（如迟发性运动障碍和迟发性静坐不能）以及心因性震颤区分开来。尽管这些技术也可能有助于将抗精神病药物所致震颤与某些震颤障碍（如扑翼样震颤或共济失调性震颤）区分开来，但其将抗精神病药物所致震颤与其他类型的器质性震颤区分开来的总体潜力较为有限。
