The long-term outcome of orthostatic tremor
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The long-term outcome of orthostatic tremor. / Ganos, Christos; Maugest, Lucie; Apartis, Emmanuelle; Gasca-Salas, Carmen; Cáceres-Redondo, María T; Erro, Roberto; Navalpotro-Gómez, Irene; Batla, Amit; Antelmi, Elena; Degos, Bertrand; Roze, Emmanuel; Welter, Marie-Laure; Mestre, Tiago; Palomar, Francisco J; Isayama, Reina; Chen, Robert; Cordivari, Carla; Mir, Pablo; Lang, Anthony E; Fox, Susan H; Bhatia, Kailash P; Vidailhet, Marie.
In: J NEUROL NEUROSUR PS, Vol. 87, No. 2, 02.2016, p. 167-72.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - The long-term outcome of orthostatic tremor
AU - Ganos, Christos
AU - Maugest, Lucie
AU - Apartis, Emmanuelle
AU - Gasca-Salas, Carmen
AU - Cáceres-Redondo, María T
AU - Erro, Roberto
AU - Navalpotro-Gómez, Irene
AU - Batla, Amit
AU - Antelmi, Elena
AU - Degos, Bertrand
AU - Roze, Emmanuel
AU - Welter, Marie-Laure
AU - Mestre, Tiago
AU - Palomar, Francisco J
AU - Isayama, Reina
AU - Chen, Robert
AU - Cordivari, Carla
AU - Mir, Pablo
AU - Lang, Anthony E
AU - Fox, Susan H
AU - Bhatia, Kailash P
AU - Vidailhet, Marie
N1 - Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
PY - 2016/2
Y1 - 2016/2
N2 - OBJECTIVES: Orthostatic tremor is a rare condition characterised by high-frequency tremor that appears on standing. Although the essential clinical features of orthostatic tremor are well established, little is known about the natural progression of the disorder. We report the long-term outcome based on the largest multicentre cohort of patients with orthostatic tremor.METHODS: Clinical information of 68 patients with clinical and electrophysiological diagnosis of orthostatic tremor and a minimum follow-up of 5 years is presented.RESULTS: There was a clear female preponderance (76.5%) with a mean age of onset at 54 years. Median follow-up was 6 years (range 5-25). On diagnosis, 86.8% of patients presented with isolated orthostatic tremor and 13.2% had additional neurological features. At follow-up, seven patients who initially had isolated orthostatic tremor later developed further neurological signs. A total 79.4% of patients reported worsening of orthostatic tremor symptoms. These patients had significantly longer symptom duration than those without reported worsening (median 15.5 vs 10.5 years, respectively; p=0.005). There was no change in orthostatic tremor frequency over time. Structural imaging was largely unremarkable and dopaminergic neuroimaging (DaTSCAN) was normal in 18/19 cases. Pharmacological treatments were disappointing. Two patients were treated surgically and showed improvement.CONCLUSIONS: Orthostatic tremor is a progressive disorder with increased disability although tremor frequency is unchanged over time. In most cases, orthostatic tremor represents an isolated syndrome. Drug treatments are unsatisfactory but surgery may hold promise.
AB - OBJECTIVES: Orthostatic tremor is a rare condition characterised by high-frequency tremor that appears on standing. Although the essential clinical features of orthostatic tremor are well established, little is known about the natural progression of the disorder. We report the long-term outcome based on the largest multicentre cohort of patients with orthostatic tremor.METHODS: Clinical information of 68 patients with clinical and electrophysiological diagnosis of orthostatic tremor and a minimum follow-up of 5 years is presented.RESULTS: There was a clear female preponderance (76.5%) with a mean age of onset at 54 years. Median follow-up was 6 years (range 5-25). On diagnosis, 86.8% of patients presented with isolated orthostatic tremor and 13.2% had additional neurological features. At follow-up, seven patients who initially had isolated orthostatic tremor later developed further neurological signs. A total 79.4% of patients reported worsening of orthostatic tremor symptoms. These patients had significantly longer symptom duration than those without reported worsening (median 15.5 vs 10.5 years, respectively; p=0.005). There was no change in orthostatic tremor frequency over time. Structural imaging was largely unremarkable and dopaminergic neuroimaging (DaTSCAN) was normal in 18/19 cases. Pharmacological treatments were disappointing. Two patients were treated surgically and showed improvement.CONCLUSIONS: Orthostatic tremor is a progressive disorder with increased disability although tremor frequency is unchanged over time. In most cases, orthostatic tremor represents an isolated syndrome. Drug treatments are unsatisfactory but surgery may hold promise.
KW - Age of Onset
KW - Aged
KW - Aged, 80 and over
KW - Cohort Studies
KW - Disease Progression
KW - Dopaminergic Neurons
KW - Female
KW - Follow-Up Studies
KW - Humans
KW - Male
KW - Middle Aged
KW - Neuroimaging
KW - Neurosurgical Procedures
KW - Sex Factors
KW - Spinal Cord Stimulation
KW - Treatment Outcome
KW - Tremor
KW - Journal Article
KW - Multicenter Study
U2 - 10.1136/jnnp-2014-309942
DO - 10.1136/jnnp-2014-309942
M3 - SCORING: Journal article
C2 - 25770124
VL - 87
SP - 167
EP - 172
JO - J NEUROL NEUROSUR PS
JF - J NEUROL NEUROSUR PS
SN - 0022-3050
IS - 2
ER -