Patients with adult-onset dystonic tremor resembling parkinsonian tremor have scans without evidence of dopaminergic deficit (swedds)
Abstract
We present the clinical details and dopamine transporter SPECT scan results of 10 patients with arm tremor, including a rest component and reduced arm swing on the affected side, in whom the possibility of PD had been raised. All patients had signs of dystonia or components of their arm tremor that were compatible with dystonic tremor, and none had true akinesia with fatiguing or decrement, even after a mean follow‐up period of 5.8 years. All patients had normal dopamine transporter SPECT scans. Clinicians should be aware that primary adult‐onset dystonia can present with an asymmetric resting arm tremor, with impaired arm swing and sometimes also facial hypomimia or a jaw tremor, but without evidence of true akinesia. Given the important consequences of misdiagnosing such patients as PD, in cases with diagnostic uncertainty functional imaging should be considered. Among patients suspected of PD, dystonic tremor may be one cause of SWEDDs (Scans Without Evidence of Dopaminergic Deficit). © 2007 Movement Disorder Society
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Clear diagnosis of PD requires a series of relevant symptoms based on the UKPDS Brain Bank Criteria, which normally takes no less than 5 years to confirm.
“the clear diagnosis of PD requires a series of relevant symptoms based on the UKPDS Brain Bank Criteria, which takes a long period, normally no less than 5 years, to confirm (Schneider et al., 2007).”
From A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor (2018) · cites this paper as Schneider et al., 2007
Resting tremor may not occur until years after onset.
“In addition, resting tremor may not occur until years after onset (Schneider et al., 2007).”
From A Novel Posture for Better Differentiation Between Parkinson's Tremor and Essential Tremor (2018) · cites this paper as Schneider et al., 2007
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- Authors
- Schneider, S. A., Edwards, M. J., Mir, P., Cordivari, C., Hooker, J., Dickson, J., Quinn, N., & Bhatia, K. P.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- University College London (GB)
- Corresponding author
- Bhatia, Kailash P.
- ORCID
- Venue
- Movement Disorders
- Publisher
- Wiley
- Published
- 2007-08-21
- Volume
- 22
- Issue
- 15
- Pages
- 2210-2215
- ISSN
- 0885-3185 (ISSN-L)
- 1531-8257
- OpenAlex
- W2085064821
- Cited by
- 247
- References
- 16
- Citations by year
- 2026: 6 · 2025: 5 · 2024: 7 · 2023: 5 · 2022: 9 · 2021: 10 · 2020: 15 · 2019: 3 · 2018: 12 · 2017: 14 · 2016: 16 · 2015: 20 · 2014: 17 · 2013: 18 · 2012: 26
- FWCI
- 9.40
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Movement Disorders (publishedVersion)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Topics
- Health Sciences › Medicine › Neurology › Neurological disorders and treatments
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Endocrinology, Diabetes and Metabolism › Neurological and metabolic disorders
- Keywords
- adult-onset dystonia, dystonic tremor, parkinsonian tremor, dopamine transporter SPECT, arm tremor, jaw tremor, akinesia, functional imaging
- MeSH terms
- Aged, Aged, 80 and over, Dopamine, Dystonia, Electromyography, Female, Humans, Male, Middle Aged, Tomography, Emission-Computed, Single-Photon, Age of Onset, Essential Tremor, Parkinsonian Disorders, Dopamine Plasma Membrane Transport Proteins
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