+ Site Statistics
+ Search Articles
+ PDF Full Text Service
How our service works
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ Translate
+ Recently Requested

Distinguishing the tremor of Parkinson's disease from essential tremor: finger displacement

Distinguishing the tremor of Parkinson's disease from essential tremor: finger displacement

International Journal of Neuroscience 124(3): 175-180

Although, the tremor of Parkinson's disease (PD) usually, but not always, differs from essential tremor (ET), there is no simple bedside test to distinguish PD from ET. We believe we have made such an observation. We studied 50 consecutive tremor-dominant PD patients (mean age: 63.4 years; mean disease duration: 4.9 years) and 35 consecutive ET patients (mean age: 64.1 years; mean disease duration: 12.5 years). Among PD patients, 31 had a bilateral tremor and among ET patients, 29 patients had a bilateral tremor. Patients sat opposite the examiner and pointed both index fingers at the examiner's index fingers. Then they closed their eyes. Within 15 s, one or rarely both of the patient's index fingers moved, was displaced, either upward or laterally. Finger displacement occurred only with bilateral simultaneous pointing with the patient's eyes closed. All the tremor-dominant PD patients exhibited displacement of an index finger. In 46 patients, it occurred on the side of dominant tremor, in 4, it occurred bilaterally. In 31 of 35 ET patients, no displacement occurred. In 4 of 35 ET patients, it occurred unilaterally on the side of dominant tremor. Odds ratio of distinguishing PD from ET: 89.62 at 95% confidence limits (5.31-1513.4), p = 0. 0018. Sensitivity 100% (0.91-1), specificity 89% (0.72-0.96). Finger displacement can distinguish the tremor of PD from ET. The unilateral movement with eyes closed suggests the tremor of PD unlike ET may impact circuits involving the parietal and supplementary motor cortices.

Please choose payment method:

(PDF emailed within 0-6 h: $19.90)

Accession: 052665432

Download citation: RISBibTeXText

PMID: 23879402

DOI: 10.3109/00207454.2013.828287

Related references

Distinguishing the central drive to tremor in Parkinson's disease and essential tremor. Journal of Neuroscience 35(2): 795-806, 2015

Differential Diagnosis of Parkinson Disease, Essential Tremor, and Enhanced Physiological Tremor with the Tremor Analysis of EMG. Parkinson's Disease 2017: 1597907, 2017

Synchronous pattern distinguishes resting tremor associated with essential tremor from rest tremor of Parkinson's disease. Parkinsonism and Related Disorders 17(1): 30-33, 2011

Essential tremor and tremor in Parkinson's disease are associated with distinct 'tremor clusters' in the ventral thalamus. Experimental Neurology 237(2): 435-443, 2012

Magnetic resonance support vector machine discriminates essential tremor with rest tremor from tremor-dominant Parkinson disease. Movement Disorders 29(9): 1216-1219, 2014

P935: Distinguishing essential tremor from parkinsonian tremor: differences in spatiotemporal parameters in a 3D tremor analysis. Clinical Neurophysiology 125: S295-S296, 2014

Hand Tremor Questionnaire: A Useful Screening Tool for Differentiating Patients with Hand Tremor between Parkinson's Disease and Essential Tremor. Journal of Clinical Neurology 14(3): 381-386, 2018

H-reflex recovery curves differentiate essential tremor, Parkinson's disease, and the combination of essential tremor and Parkinson's disease. Journal of Clinical Neurophysiology 19(3): 245-251, 2002

Distinguishing Parkinson's disease and essential tremor with transcranial sonography. Acta Neurologica Scandinavica 119(1): 17-21, 2008

A clinical maneuver to increase tremor differentiation between Parkinson disease and essential tremor. European Journal of Neurology 17(9): E89, 2010

Complex tremor analysis for the differential diagnosis of essential tremor and Parkinson's disease. Ideggyogyaszati Szemle 59(1-2): 45-54, 2006

More Time with Tremor: The Experience of Essential Tremor Versus Parkinson's Disease Patients. Movement Disorders Clinical Practice 3(1): 36-42, 2016

Evaluating the electrophysiological features of tremor in Parkinson's disease and essential tremor using accelerometry. Zhonghua Yi Xue Za Zhi 96(41): 3289-3293, 2016

Eye movement abnormalities in essential tremor versus tremor dominant Parkinson's disease. Clinical Neurophysiology 130(5): 683-691, 2019

A longitudinal study of tremor frequencies in Parkinson's disease and essential tremor. Clinical Neurophysiology 120(2): 431-435, 2009