Gait abnormality in essential tremor.
Essential tremor (ET) has been described as a monosymptomatic disorder. In reports describing large series of patients with ET, there are rare patients who exhibit a noticeable gait disorder. However, we have observed that patients with ET and normal gait often exhibit an abnormality of tandem gait. To investigate this observation, we examined whether a gait disorder was present in 36 consecutive patients (mean age 69) with ET. We employed a tremor rating scale that scored tremor amplitude, location, and disability. In all patients, gait and tandem gait were separately evaluated. Eighteen of 36 patients (50%) exhibited tandem gait abnormalities in the presence of a normal narrow-based gait compared to 11 of 40 age-matched controls (28%) (p < 0.05). Abnormality of tandem gait was more frequently present in older ET patients and those with > 5 years of disease duration. No relationship was found between presence of tandem gait abnormality and gender, tremor severity, head involvement, or positive family history. The finding of a tandem gait abnormality in 50% of ET patients suggests that cerebellar dysfunction may be important in its pathophysiology.
Singer
C
C
Department of Neurology, University of Miami School of Medicine, Florida.
Sanchez-Ramos
J
J
Weiner
W J
WJ
D000368:Aged; D002524:Cerebellar Ataxia / Q000503:physiopathology; D002531:Cerebellum / Q000503:physiopathology; D005260:Female; D005684:Gait / Q000502:physiology*; D006801:Humans; D008124:Locomotion / Q000502:physiology; D008297:Male; D009460:Neurologic Examination; D009847:Olivary Nucleus / Q000503:physiopathology; D011149:Pons / Q000503:physiopathology; D014202:Tremor / Q000503:physiopathology*