Myoclonus or tremor in orthostatism: An under‐recognized cause of unsteadiness in Parkinson's disease
Identifieur interne : 003C51 ( Main/Merge ); précédent : 003C50; suivant : 003C52Myoclonus or tremor in orthostatism: An under‐recognized cause of unsteadiness in Parkinson's disease
Auteurs : Smaranda Leu-Semenescu [France] ; Emmanuel Roze [France] ; Marie Vidailhet [France] ; André-Pierre Legrand [France] ; Jean-Marc Trocello [France] ; Valérie Cochen [France] ; Sophie Sangla [France] ; Emmanuelle Apartis [France]Source :
- Movement Disorders [ 0885-3185 ] ; 2007-10-31.
English descriptors
- KwdEn :
- Adult, Aged, Aged, 80 and over, Electromyography, Female, Humans, Hypotension, Orthostatic (etiology), Male, Middle Aged, Muscle Rigidity (etiology), Myoclonus (complications), Parkinson Disease (physiopathology), Parkinson's disease, Retrospective Studies, Tremor (complications), myoclonus, neurophysiology, orthostatic tremor, unsteadiness.
- MESH :
- complications : Myoclonus, Tremor.
- etiology : Hypotension, Orthostatic, Muscle Rigidity.
- physiopathology : Parkinson Disease.
- Adult, Aged, Aged, 80 and over, Electromyography, Female, Humans, Male, Middle Aged, Retrospective Studies.
Abstract
Patients with Parkinson's disease (PD) often complain of unsteadiness. This can occur as the result of various neurological dysfunctions, including changes in postural adjustments, loss of postural reflexes, axial akinesia and rigidity, freezing and/or postural hypotension. In some cases these symptoms remain unexplained, and rare cases of unsteadiness have been attributed to tremor on standing. To delineate this condition, we investigated 11 consecutive PD patients with unexplained unsteadiness because of tremor on standing, seen in our department over a 6‐year period. All the patients had detailed clinical and electrophysiological investigations based on surface polygraphic electromyographic recordings. Four patients had fast orthostatic tremor (13–18 Hz), one had intermediate orthostatic tremor (8–9 Hz), and three had slow orthostatic tremor (4–6 Hz). The remaining 3 patients had orthostatic myoclonus, a condition that has not previously been reported in PD. Patients with fast tremor improved on clonazepam. Patients with slow tremor and myoclonus improved on levodopa and sometimes benefited further when clonazepam was added. These observations show the usefulness of neurophysiological investigations for diagnosing and treating unexplained unsteadiness in Parkinson's disease. © 2007 Movement Disorder Society
Url:
DOI: 10.1002/mds.21651
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<front><div type="abstract" xml:lang="en">Patients with Parkinson's disease (PD) often complain of unsteadiness. This can occur as the result of various neurological dysfunctions, including changes in postural adjustments, loss of postural reflexes, axial akinesia and rigidity, freezing and/or postural hypotension. In some cases these symptoms remain unexplained, and rare cases of unsteadiness have been attributed to tremor on standing. To delineate this condition, we investigated 11 consecutive PD patients with unexplained unsteadiness because of tremor on standing, seen in our department over a 6‐year period. All the patients had detailed clinical and electrophysiological investigations based on surface polygraphic electromyographic recordings. Four patients had fast orthostatic tremor (13–18 Hz), one had intermediate orthostatic tremor (8–9 Hz), and three had slow orthostatic tremor (4–6 Hz). The remaining 3 patients had orthostatic myoclonus, a condition that has not previously been reported in PD. Patients with fast tremor improved on clonazepam. Patients with slow tremor and myoclonus improved on levodopa and sometimes benefited further when clonazepam was added. These observations show the usefulness of neurophysiological investigations for diagnosing and treating unexplained unsteadiness in Parkinson's disease. © 2007 Movement Disorder Society</div>
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<front><div type="abstract" xml:lang="en">Patients with Parkinson's disease (PD) often complain of unsteadiness. This can occur as the result of various neurological dysfunctions, including changes in postural adjustments, loss of postural reflexes, axial akinesia and rigidity, freezing and/or postural hypotension. In some cases these symptoms remain unexplained, and rare cases of unsteadiness have been attributed to tremor on standing. To delineate this condition, we investigated 11 consecutive PD patients with unexplained unsteadiness because of tremor on standing, seen in our department over a 6‐year period. All the patients had detailed clinical and electrophysiological investigations based on surface polygraphic electromyographic recordings. Four patients had fast orthostatic tremor (13–18 Hz), one had intermediate orthostatic tremor (8–9 Hz), and three had slow orthostatic tremor (4–6 Hz). The remaining 3 patients had orthostatic myoclonus, a condition that has not previously been reported in PD. Patients with fast tremor improved on clonazepam. Patients with slow tremor and myoclonus improved on levodopa and sometimes benefited further when clonazepam was added. These observations show the usefulness of neurophysiological investigations for diagnosing and treating unexplained unsteadiness in Parkinson's disease. © 2007 Movement Disorder Society</div>
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<PubMed><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Myoclonus or tremor in orthostatism: an under-recognized cause of unsteadiness in Parkinson's disease.</title>
<author><name sortKey="Leu Semenescu, Smaranda" sort="Leu Semenescu, Smaranda" uniqKey="Leu Semenescu S" first="Smaranda" last="Leu-Semenescu">Smaranda Leu-Semenescu</name>
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<author><name sortKey="Roze, Emmanuel" sort="Roze, Emmanuel" uniqKey="Roze E" first="Emmanuel" last="Roze">Emmanuel Roze</name>
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<author><name sortKey="Vidailhet, Marie" sort="Vidailhet, Marie" uniqKey="Vidailhet M" first="Marie" last="Vidailhet">Marie Vidailhet</name>
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<author><name sortKey="Legrand, Andre Pierre" sort="Legrand, Andre Pierre" uniqKey="Legrand A" first="André-Pierre" last="Legrand">André-Pierre Legrand</name>
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<author><name sortKey="Trocello, Jean Marc" sort="Trocello, Jean Marc" uniqKey="Trocello J" first="Jean-Marc" last="Trocello">Jean-Marc Trocello</name>
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<author><name sortKey="Cochen, Valerie" sort="Cochen, Valerie" uniqKey="Cochen V" first="Valérie" last="Cochen">Valérie Cochen</name>
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<country xml:lang="fr">France</country>
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</author>
<author><name sortKey="Roze, Emmanuel" sort="Roze, Emmanuel" uniqKey="Roze E" first="Emmanuel" last="Roze">Emmanuel Roze</name>
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<author><name sortKey="Vidailhet, Marie" sort="Vidailhet, Marie" uniqKey="Vidailhet M" first="Marie" last="Vidailhet">Marie Vidailhet</name>
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<author><name sortKey="Legrand, Andre Pierre" sort="Legrand, Andre Pierre" uniqKey="Legrand A" first="André-Pierre" last="Legrand">André-Pierre Legrand</name>
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<author><name sortKey="Trocello, Jean Marc" sort="Trocello, Jean Marc" uniqKey="Trocello J" first="Jean-Marc" last="Trocello">Jean-Marc Trocello</name>
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<author><name sortKey="Cochen, Valerie" sort="Cochen, Valerie" uniqKey="Cochen V" first="Valérie" last="Cochen">Valérie Cochen</name>
</author>
<author><name sortKey="Sangla, Sophie" sort="Sangla, Sophie" uniqKey="Sangla S" first="Sophie" last="Sangla">Sophie Sangla</name>
</author>
<author><name sortKey="Apartis, Emmanuelle" sort="Apartis, Emmanuelle" uniqKey="Apartis E" first="Emmanuelle" last="Apartis">Emmanuelle Apartis</name>
</author>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
<idno type="ISSN">0885-3185</idno>
<imprint><date when="2007" type="published">2007</date>
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<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Electromyography</term>
<term>Female</term>
<term>Humans</term>
<term>Hypotension, Orthostatic (etiology)</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Muscle Rigidity (etiology)</term>
<term>Myoclonus (complications)</term>
<term>Parkinson Disease (physiopathology)</term>
<term>Retrospective Studies</term>
<term>Tremor (complications)</term>
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<keywords scheme="MESH" qualifier="complications" xml:lang="en"><term>Myoclonus</term>
<term>Tremor</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Hypotension, Orthostatic</term>
<term>Muscle Rigidity</term>
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<keywords scheme="MESH" qualifier="physiopathology" xml:lang="en"><term>Parkinson Disease</term>
</keywords>
<keywords scheme="MESH" xml:lang="en"><term>Adult</term>
<term>Aged</term>
<term>Aged, 80 and over</term>
<term>Electromyography</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Retrospective Studies</term>
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<front><div type="abstract" xml:lang="en">Patients with Parkinson's disease (PD) often complain of unsteadiness. This can occur as the result of various neurological dysfunctions, including changes in postural adjustments, loss of postural reflexes, axial akinesia and rigidity, freezing and/or postural hypotension. In some cases these symptoms remain unexplained, and rare cases of unsteadiness have been attributed to tremor on standing. To delineate this condition, we investigated 11 consecutive PD patients with unexplained unsteadiness because of tremor on standing, seen in our department over a 6-year period. All the patients had detailed clinical and electrophysiological investigations based on surface polygraphic electromyographic recordings. Four patients had fast orthostatic tremor (13-18 Hz), one had intermediate orthostatic tremor (8-9 Hz), and three had slow orthostatic tremor (4-6 Hz). The remaining 3 patients had orthostatic myoclonus, a condition that has not previously been reported in PD. Patients with fast tremor improved on clonazepam. Patients with slow tremor and myoclonus improved on levodopa and sometimes benefited further when clonazepam was added. These observations show the usefulness of neurophysiological investigations for diagnosing and treating unexplained unsteadiness in Parkinson's disease.</div>
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