Diagnostic Testing in Movement Disorders

Anouti, Ahmad

doi:10.1016/s0733-8619(05)70248-6

Cited by 12 publications

(8 citation statements)

References 43 publications

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“…6,7 According to the American Academy of Neurology guidelines, treatment with β-blockers (e.g., propranolol) or anticonvulsants (e.g., primadone) should be started when the tremor results in functional disability or social embarrassment (Appendix 3 available at www.cmaj.ca/lookup/suppl/doi:10.1503/cmaj .120496/-/DC1). 8,9 Although these guidelines are based on studies involving adults, a paucity of studies involving children necessitates that current practice extrapolate this evidence to tremor in children.…”

Section: Essential Tremormentioning

confidence: 99%

“…1 Once intention tremor is noted, CT or MRI is the most important tool for ruling out focal lesions (Appendix 3). 8 In situations where treating the underlying disease is feasible, tremor may improve after the pathologic cause is removed.…”

Section: Intention Tremormentioning

confidence: 99%

“…Tremor in the legs should be evaluated with the legs at rest, during heel-to-shin testing and while the patient is standing and walking. 5,8 Postural and other action tremors are best elicited with the patient's arms outstretched, during finger-to-nose manoeuvres, and while the patient drinks from a cup and performs written tasks. With intention tremor, associated symptoms such as nystagmus, dysarthria, dysmetria and gait ataxia should be investigated.…”

Section: Diagnostic Approachmentioning

confidence: 99%

“…Standard laboratory evaluation of tremor should include a chemistry profile (i.e., levels of glucose and liver enzymes and INR), complete blood count and thyroid function tests. 5 Addi- 5,8 Imaging of the brain should be ordered if a structural or metabolic cause of tremor is suspected, such as space-occupying lesions, multiple sclerosis, trauma or stroke. Urgent CT is often used in acute care settings, but it should be used judiciously because of the risk of substantial radiation exposure.…”

Section: Diagnostic Approachmentioning

confidence: 99%

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Two children with tremor

Liu

Pringsheim

Thompson

2014

CMAJ

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A right-handed 14-year-old boy was referred to a neurologist for an outpatient evaluation of tremor. The boy was previously healthy and not taking any medications. Developmental milestones were achieved within the appropriate norms. There was a family history of tremor in the boy's mother and maternal uncle. The mother reported that her tremor lessened following the consumption of alcohol. The parents first noticed the tremor in their son when he was about six years old. The tremor occurred mainly during voluntary activity, such as writing, eating soup with a spoon, drinking from a cup and using his hands for small skilled movements. The tremor affected both arms and was worse on the right side. His head, voice and legs were unaffected. The tremor was worse when he was physically tired (e.g., after heavy lifting) or nervous (e.g., public speaking). Over the years, the tremor has worsened slightly and has become a source of embarrassment to him.On examination, the patient showed no distress and had normal vital signs; he was alert, behaved appropriately and had age-appropriate speech and language. Results of a cranial nerve examination were normal. A motor system examination showed normal bulk and tone. Strength in the upper and lower limbs was graded as 5 out of 5 in a manual muscle test. Results of sensory and gait examinations were normal. He was able to walk without difficulty using a tandem gait.

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Section: Essential Tremormentioning

confidence: 99%

Section: Intention Tremormentioning

confidence: 99%

Section: Diagnostic Approachmentioning

confidence: 99%

Section: Diagnostic Approachmentioning

confidence: 99%

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Two children with tremor

Liu

Pringsheim

Thompson

2014

CMAJ

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“…Therefore, the primary rationale behind obtaining a neuroimaging study in a patient with parkinsonism is not to confirm a diagnosis of PD, but to determine if a multisystem degenerative or vascular form of parkinsonism is present. In a survey of 49 movement disorder specialists, Anouti and Koller (1996) found that CT or MRI scans were ordered between 76% to 100% of the time to evaluate patients with suspected non-PD akinetic-rigid syndromes. Surprisingly, in the same survey, these studies were ordered 50% to 75% of the time in patients with a clinical diagnosis of PD.…”

Section: Neuroimaging and Neurophysiological Tests In The Diagnosis O...mentioning

confidence: 99%

Parkinson's Disease

Hobson

2008

Handbook of the Clinical Psychology of Ageing

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Labordiagnostik hyperkinetischer Bewegungsstörungen des Erwachsenenalters

Laubis-Herrmann¹,

Topka²

2002

Der Nervenarzt

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Hyperkinetic movement disorders such as dystonia, chorea, ballism, myoclonus, tics, and tremor may be idiopathic or symptomatic in origin. Symptomatic movement disorders need further diagnostic testing in order to identify their etiology. In addition to clinical findings, imaging techniques, and electrophysiological testing, laboratory studies are required. Here, we review the prevalence of diseases presenting with symptomatic hyperkinetic movement disorders and discuss the diagnostic relevance of laboratory studies.

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Diagnostic Testing in Movement Disorders

Cited by 12 publications

References 43 publications

Two children with tremor

Two children with tremor

Parkinson's Disease

Labordiagnostik hyperkinetischer Bewegungsstörungen des Erwachsenenalters

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