Distinguishing features between valproate-induced tremor and essential tremor

Abstract

Patients with valproate-induced tremor requiring pharmacological treatment have similar distribution, CRST scores, and functional impact than those with ET.

Clinical and Kinematic Features of Valproate-Induced Tremor and Differences with Essential Tremor

“…Another clinical observation of our study was the frequent tremor involvement of not only the upper limbs but also the cranial district (head and voice) and lower limbs, which again was higher than previously reported [2,14]. Differences in terms of rest tremor and body distribution of tremor in VIT between our study and previous reports may be due to demographic and clinical differences, such as the younger age and shorter disease duration of VIT patients in previous reports [14] compared with our study. This issue is relevant because VIT is thought to progress over time and earlier evaluation of patients may lead to underestimation of VIT features.…”

“…Results of the clinical assessment showed that VIT is characterized by bilateral postural and kinetic tremor of the upper limbs in all cases, and by the occurrence of upper limb rest tremor in a relatively high proportion of patients. With respect to previous studies, we found a relatively high occurrence of rest tremor in our sample [ 5 , 10 , 13 , 14 ]. Another clinical observation of our study was the frequent tremor involvement of not only the upper limbs but also the cranial district (head and voice) and lower limbs, which again was higher than previously reported [ 2 , 14 ].…”

“…With respect to previous studies, we found a relatively high occurrence of rest tremor in our sample [ 5 , 10 , 13 , 14 ]. Another clinical observation of our study was the frequent tremor involvement of not only the upper limbs but also the cranial district (head and voice) and lower limbs, which again was higher than previously reported [ 2 , 14 ]. Differences in terms of rest tremor and body distribution of tremor in VIT between our study and previous reports may be due to demographic and clinical differences, such as the younger age and shorter disease duration of VIT patients in previous reports [ 14 ] compared with our study.…”

“…A limited number of studies have characterised VIT from a neurophysiological point of view [5,[10][11][12]. Overall, these studies have indicated that VIT mainly consists of postural tremor of the upper limbs with a low amplitude and relatively high frequency (ranging from 6 to 15 Hz), though rest tremor of the upper limbs has also been confirmed in some patients [5,10,13,14]. However, no previous neurophysiological studies on VIT have comprehensively assessed tremor by considering activation conditions (postural, kinetic and rest tremor) and body distribution, as proposed by the new consensus statement [1].…”

“…Like VIT, essential tremor (ET) is a common movement disorder characterized by postural and kinetic tremor of the upper limbs [1]. ET is clinically heterogeneous, and its diagnosis is often challenging since differences in clinical and neurophysiological features between VIT and ET have been scarcely investigated [14]. A comparison study may help in the differential diagnosis between VIT and ET and may provide further insight into the pathophysiological mechanisms of both tremor types.…”