Essential tremor is commonly considered as a benign and high prevalence disease; however its study is not systematized even in its definition. Methods: We did a literature review related to essential tremor enhanced with our own experience in this matter. Results: We performed a critical review of different issues of essential tremor from definition to association to others neurological diseases. We focused on controversial points and lesser known issues by a non specialist physician. Discussion: We analyzed the complexity of this disease, its association with other neurological diseases, in particular Parkinson disease and cognitive decline. We proposed different variants of essential tremor according prognosis. Conclusion: Essential tremor is a heterogeneous disease from clinical and etiological point of view. There are variants with different long term outcome.
Two cases of progressive anarthria are reported; we remarck their close but distinct relation with speech apraxia. Both of them were older female, with a progressive loss of speech, bilateral paresis of lower face, tongue and palatal muscles. They also had mild pyramidal signs and a fronto-subcortical cognitive deterioration. Brain TC and MRI were within normal limits. One of them had a possible progressive supranuclear palsy, the other one a possible corticobasal degeneration. The analysis of similar cases reports let us to conclude than there are several pathologies that can cause a progressive pseudobulbar palsy. The final diagnosis must be by postmortem examination of the brain.
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