Psychogenic tremor: long-term prognosis in patients with electrophysiologically confirmed disease.
Identifieur interne : 001C18 ( PubMed/Checkpoint ); précédent : 001C17; suivant : 001C19Psychogenic tremor: long-term prognosis in patients with electrophysiologically confirmed disease.
Auteurs : Andrew Mckeon [États-Unis] ; J Eric Ahlskog ; James H. Bower ; Keith A. Josephs ; Joseph Y. MatsumotoSource :
- Movement disorders : official journal of the Movement Disorder Society [ 1531-8257 ] ; 2009.
English descriptors
- KwdEn :
- Adolescent, Adult, Age of Onset, Aged, Behavior Therapy, Cohort Studies, Comorbidity, Conversion Disorder (diagnosis), Conversion Disorder (epidemiology), Conversion Disorder (physiopathology), Conversion Disorder (psychology), Conversion Disorder (rehabilitation), Disease Progression, Electromyography, Female, Follow-Up Studies, Humans, Hypnosis, Male, Middle Aged, Neurologic Examination, Patient Compliance, Prognosis, Questionnaires, Remission, Spontaneous, Severity of Illness Index, Tremor (diagnosis), Tremor (epidemiology), Tremor (physiopathology), Tremor (psychology), Tremor (rehabilitation), Young Adult.
- MESH :
- diagnosis : Conversion Disorder, Tremor.
- epidemiology : Conversion Disorder, Tremor.
- physiopathology : Conversion Disorder, Tremor.
- psychology : Conversion Disorder, Tremor.
- rehabilitation : Conversion Disorder, Tremor.
- Adolescent, Adult, Age of Onset, Aged, Behavior Therapy, Cohort Studies, Comorbidity, Disease Progression, Electromyography, Female, Follow-Up Studies, Humans, Hypnosis, Male, Middle Aged, Neurologic Examination, Patient Compliance, Prognosis, Questionnaires, Remission, Spontaneous, Severity of Illness Index, Young Adult.
Abstract
We describe the presenting features and long-term outcomes of patients with electrophysiologically-confirmed psychogenic tremor. Clinical information for all patients with psychogenic tremor confirmed by our Movement Disorders Neurophysiology Laboratory (2003-2004) was reviewed. A follow-up questionnaire was administered to all included patients in 2007. Psychogenic tremor was documented in 62 patients; 33 responded to the questionnaire (53%). Median onset-age was 50 years (range, 15-71); 23 were female (70%). Clinical certainty of psychogenic etiology was: definite, 8 (24%); probable, 16 (49%), and possible, 9 (27%). Characteristic electrodiagnostic features of psychogenic tremor were documented in all. All but two patients were ultimately given a definite diagnosis of psychogenic tremor; recommended psychiatric consultation was only done by 12 (36%). Twenty-one patients (64%) rated tremor disability as moderate or severe after a median follow-up of 5.1 years (range, 3.3-19). Improvement occurred spontaneously in 5 (15%), and after a specific intervention in 4 (12%), whereas 3 (9%) had mild but unchanged symptoms. The mean duration of symptoms, prior to diagnosis with psychogenic tremor, was significantly shorter for patients with mild or no tremor at follow-up (P = 0.037). Physiologically-confirmed psychogenic tremor carries a poor prognosis, with unremitting or worse tremor persisting 3-years after diagnosis in most.
DOI: 10.1002/mds.22301
PubMed: 18831532
Affiliations:
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<term>Tremor (diagnosis)</term>
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<front><div type="abstract" xml:lang="en">We describe the presenting features and long-term outcomes of patients with electrophysiologically-confirmed psychogenic tremor. Clinical information for all patients with psychogenic tremor confirmed by our Movement Disorders Neurophysiology Laboratory (2003-2004) was reviewed. A follow-up questionnaire was administered to all included patients in 2007. Psychogenic tremor was documented in 62 patients; 33 responded to the questionnaire (53%). Median onset-age was 50 years (range, 15-71); 23 were female (70%). Clinical certainty of psychogenic etiology was: definite, 8 (24%); probable, 16 (49%), and possible, 9 (27%). Characteristic electrodiagnostic features of psychogenic tremor were documented in all. All but two patients were ultimately given a definite diagnosis of psychogenic tremor; recommended psychiatric consultation was only done by 12 (36%). Twenty-one patients (64%) rated tremor disability as moderate or severe after a median follow-up of 5.1 years (range, 3.3-19). Improvement occurred spontaneously in 5 (15%), and after a specific intervention in 4 (12%), whereas 3 (9%) had mild but unchanged symptoms. The mean duration of symptoms, prior to diagnosis with psychogenic tremor, was significantly shorter for patients with mild or no tremor at follow-up (P = 0.037). Physiologically-confirmed psychogenic tremor carries a poor prognosis, with unremitting or worse tremor persisting 3-years after diagnosis in most.</div>
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