A teaching videotape for the assessment of essential tremor

Abstract

Teaching videotapes, developed to aid in the evaluation of several movement disorders, have not been used in essential tremor research. As part of the Washington Heights‐Inwood Genetic Study of Essential Tremor (WHIGET), we developed a reliable and valid tremor rating scale. Because this rating scale is currently being used by investigators at other centers, we developed a teaching videotape to aid in the consistent application of this scale. OBJECTIVE To develop a teaching videotape for a revised version of the WHIGET Tremor Rating Scale and to assess the interrater agreement among raters who used this videotape to rate tremor. METHODS The revised WHIGET Tremor Rating Scale was used to rate action tremor from 0 to 4 during six tests: arm extension, pouring, drinking, using a spoon, finger‐to‐nose, and drawing spirals. A 22‐minute teaching videotape was developed that includes a 29‐item educational section and a self‐assessment section consisting of 20 examples of tremor ratings chosen by the two WHIGET study neurologists. Eight raters, including senior movement disorder specialists, movement disorder fellows, general neurologists, and a movement disorder nurse practitioner, independently viewed the videotape and rated tremor during the self‐assessment section. Interobserver reliability was assessed with weighted kappa statistics (κw). RESULTS Eight raters each rated 20 items (160 ratings total). Total κw was 0.97 (nearly perfect agreement). Interrater reliability was as follows: κw = 0.99 (movement disorder specialists), κw = 0.98 (movement disorder fellows), and κw = 0.97 (general neurologists); all κw were nearly perfect. CONCLUSIONS This teaching videotape may be used to improve the uniform application of the revised WHIGET Tremor Rating Scale by raters with various levels of experience in movement disorders. Mov. Disord. 16:89–93, 2001. © 2001 Movement Disorder Society.

Identification of candidate genes for familial early-onset essential tremor

“…An in-person evaluation was performed on all participants, during which they completed demographic, medical history and family history questionnaires, and underwent a videotaped neurological examination, from which a total tremor score (range 0-36) was assigned. 10,[33][34][35][36][37] After review of the questionnaires and videotaped examinations, the diagnosis of ET was then reconfirmed by a senior neurologist specializing in movement disorders (EDL) using reliable and valid research criteria. 38 All ET diagnoses (possible, probable and definite) required, at a minimum, moderate or greater amplitude kinetic tremor on at least three tasks, and an absence of other etiologies (eg, dystonia, PD and drug-induced tremor).…”

Pallidal stimulation for Holmes tremor: clinical outcomes and single-unit recordings in 4 cases

“…Thalamic and dorsal or posterior STN DBS has been described in multiple case reports in patients with HT secondary to pontomesencephalic lesions with variable short-term results. 4,[9][10][11]25,27,29,30,33,34,[37][38][39][40]43,49,50 Recently Kobayashi et al reported 2-year outcome with dual thalamic and subthalamic area stimulation in 4 patients with HT, with significant benefit.…”

The Treatment of Tremor

“…Thus, results for zonisamide remain inconclusive (level U). Other drugs with inconclusive evidence (level U) include tiagabine (30 mg/day) and sodium oxybate (maximum dosage 4 mg three times a day) [61].…”