Long duration asymmetric postural tremor in the development of Parkinson's disease

Abstract

L ast year we said goodbye to Ian Whittle whom we thank for all his hard work and welcome Peter Warnke from Liverpool as our new Associate Editor for Neurosurgery. We also say goodbye to many members of the editorial board and welcome new faces. The vitality of the journal rests with its reviewers and authors. We listed our reviewers in the December issue and reiterate our thanks to them. With over two thousand submissions a year the burden on unpaid reviewers forever increases. In order to reduce the burden we have tried to make an early decision on priority for the journal with the result that over a third of papers do not go out to review. This will include many papers that are well conducted and worthy of publication but which we consider are not best suited to the JNNP, usually because they are too specialised. In order to assist authors with the decision of whether to submit to the journal we have revised the website guidelines. In summary we wish to attract papers of general interest to the multi-disciplinary readership of Neurologists, Psychiatrists, and Neurosurgeons. Papers should be of direct clinical relevance and so we will not generally publish papers on normal brain function nor on animal studies. We hope that these changes will provide a quick decision for our authors whilst reducing the burden on reviewers. Nevertheless prioritising between good papers remains very difficult and to assist this we have established a weekly editorial meeting.As we enter 2005 we reiterate our thanks to reviewers and authors and hope to continue to attract similar high quality manuscripts to those we have handled over the last year.

Motor Dysfunction as a Prodrome of Parkinson’s Disease

“…Their age at the onset of motor symptoms (59.4 ± 14.7 vs 56.0 ± 17.1; p=0. 19) and at the baseline study visit (63.4 ± 11.9 vs 59.7 ± 15.4; p=0.10) tended to be greater. The average time between the date of registration with the study and the diagnosis of PD was 3.1 years.…”

“…In 79 patients who met the criteria for PD, the tremor was postural / action and in three patients a monosymptomatic rest tremor occurred. There is some evidence to support a link between asymmetrical postural and action tremor and PD (19,20,28). In our series, all the patients with asymmetric tremor who developed PD also had additional subtle motor signs (19,28,29).…”

“…Between 2007 and 2008, we examined newly-referred patients with motor and non-motor symptoms for objective signs of motor dysfunction. We included people with complaints of slowness, symptoms of depression or anxiety, disturbed temperature regulation with excessive sweating, asymmetric postural tremor, orthostatic hypotension, urinary incontinence, hyposmia, REM sleep disorder, and shoulder frozen (17)(18)(19)(20)(21)(22)(23). Subtle objective motor abnormalities at baseline were identified and included 'suggestive' signs such as clumsiness, slowness or focal stiffness, and non-specific signs (see Table 1) (24,25).…”

Tremorography in the clinical practice

“…В этом случае форма болезни классифицируется как эссенциальный тремор-плюс [1]. Особенностями данного тремора покоя, в отличие от тремора при бо-лезни Паркинсона, являются: 1) отсутствие возобновляющегося тремора; 2) отсутствие «счета монет» и «скатывания пилюль»; 3) отсутствие нарастания амплитуды дрожания на треморограмме при когнитивной нагрузке [14,36].…”

Parkinson’s disease

“…However, many neurologists have seen patients with a long history of essential tremor, with postural and kinetic tremor of the hands, sometimes with associated yes-yes head tremor, which progresses after many years into unequivocal Parkinson's disease. 48 Although the presence of rest tremor is helpful for the diagnosis of Parkinson's disease, a similar tremor can occur in some cases of dystonic and atypical tremor syndromes. 49 Flexion of the limbs and trunk is characteristic of Parkinson's disease, and some patients have transient fi xed posturing of a hand after completing a motor task (catalepsy).…”