Multiple sclerosis tremor and the Stewart-Holmes manoeuvre.
Identifieur interne : 000B27 ( Ncbi/Curation ); précédent : 000B26; suivant : 000B28Multiple sclerosis tremor and the Stewart-Holmes manoeuvre.
Auteurs : Emmanuelle Waubant [France] ; Sophie Tezenas Du Montcel ; Charles Jedynak ; Michael Obadia ; Hassan Hosseini ; Philippe Damier ; Catherine Lubetzki ; Yves Agid [France] ; Jean-Denis DegosSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2003.
English descriptors
- KwdEn :
- Adult, Cerebellar Diseases (complications), Cerebellar Diseases (diagnosis), Cerebellar Diseases (physiopathology), Diagnosis, Differential, Female, Humans, Male, Multiple Sclerosis (complications), Multiple Sclerosis (diagnosis), Multiple Sclerosis (physiopathology), Posture (physiology), Severity of Illness Index, Tremor (diagnosis), Tremor (etiology), Tremor (physiopathology).
- MESH :
- complications : Cerebellar Diseases, Multiple Sclerosis.
- diagnosis : Cerebellar Diseases, Multiple Sclerosis, Tremor.
- etiology : Tremor.
- physiology : Posture.
- physiopathology : Cerebellar Diseases, Multiple Sclerosis, Tremor.
- Adult, Diagnosis, Differential, Female, Humans, Male, Severity of Illness Index.
Abstract
The objective of this study is to define tremor and cerebellar dysfunction and determine whether kinetic and postural tremor correlate with cerebellar dysfunction in patients with multiple sclerosis (MS). Cerebellar symptoms such as dysmetria often interfere with tremor evaluation in MS. The Stewart-Holmes (SH) manoeuvre, which has been recently quantified, may offer a selective evaluation of cerebellar dysfunction in such patients. Thirty-two patients with definite MS and arm tremor were evaluated (simplified Fahn tremor scale for kinetic and postural tremor, finger-to-nose test, clinical SH manoeuvre, quantitative study of the SH manoeuvre). Median severity of kinetic and postural tremor on the most disabled side was, respectively, 2 (range 0-4) and 1.5 (range 0-4). Clinical SH scores were moderately correlated to quantified SH measures (r = 0.36, P < 0.05). Kinetic and postural tremors were strongly correlated (r = 0.73, P < 0.0001) but did not correlate with clinical or quantified SH scores. Patients with bilateral tremor had higher scores for quantified SH, and a trend to higher clinical SH and finger-to-nose scores than patients with unilateral tremor. Although clinically associated, cerebellar dysfunction and tremor may be partly independent symptoms, suggesting they may relate to dysfunction of different neuronal systems. The SH manoeuvre should be part of the evaluation of MS patients considered for surgery of tremor.
DOI: 10.1002/mds.10454
PubMed: 12889088
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pubmed:12889088Le document en format XML
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<author><name sortKey="Tezenas Du Montcel, Sophie" sort="Tezenas Du Montcel, Sophie" uniqKey="Tezenas Du Montcel S" first="Sophie" last="Tezenas Du Montcel">Sophie Tezenas Du Montcel</name>
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<author><name sortKey="Jedynak, Charles" sort="Jedynak, Charles" uniqKey="Jedynak C" first="Charles" last="Jedynak">Charles Jedynak</name>
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<term>Diagnosis, Differential</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Multiple Sclerosis (complications)</term>
<term>Multiple Sclerosis (diagnosis)</term>
<term>Multiple Sclerosis (physiopathology)</term>
<term>Posture (physiology)</term>
<term>Severity of Illness Index</term>
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<term>Tremor (etiology)</term>
<term>Tremor (physiopathology)</term>
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<term>Diagnosis, Differential</term>
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<term>Humans</term>
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<front><div type="abstract" xml:lang="en">The objective of this study is to define tremor and cerebellar dysfunction and determine whether kinetic and postural tremor correlate with cerebellar dysfunction in patients with multiple sclerosis (MS). Cerebellar symptoms such as dysmetria often interfere with tremor evaluation in MS. The Stewart-Holmes (SH) manoeuvre, which has been recently quantified, may offer a selective evaluation of cerebellar dysfunction in such patients. Thirty-two patients with definite MS and arm tremor were evaluated (simplified Fahn tremor scale for kinetic and postural tremor, finger-to-nose test, clinical SH manoeuvre, quantitative study of the SH manoeuvre). Median severity of kinetic and postural tremor on the most disabled side was, respectively, 2 (range 0-4) and 1.5 (range 0-4). Clinical SH scores were moderately correlated to quantified SH measures (r = 0.36, P < 0.05). Kinetic and postural tremors were strongly correlated (r = 0.73, P < 0.0001) but did not correlate with clinical or quantified SH scores. Patients with bilateral tremor had higher scores for quantified SH, and a trend to higher clinical SH and finger-to-nose scores than patients with unilateral tremor. Although clinically associated, cerebellar dysfunction and tremor may be partly independent symptoms, suggesting they may relate to dysfunction of different neuronal systems. The SH manoeuvre should be part of the evaluation of MS patients considered for surgery of tremor.</div>
</front>
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