title: Unusual forehead tremor in a patient with essential tremor.
abstract: Voice and head (neck) tremor commonly occur in patients with essential tremor (ET), but involvement of cranial musculature is generally limited to these specific cranial structures, and action tremor of the forehead has not been reported. We describe a patient with ET who had forehead tremor. The tremor seemed to be task-specific, and neurophysiological features suggested that the forehead tremor was dystonic. The presence of forehead tremor in a patient with ET probably indicates an additional pathophysiologic process. The explanation for the specificity of involvement of cranial musculature in ET is not known, but this clinical observation might help guide investigators who are interested in the underlying pathophysiology of this condition.
authors.affiliation: Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
authors.forename: Panida
authors.initials: P
authors.lastname: Piboolnurak
authors.affiliation: Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
authors.forename: Seth L
authors.initials: SL
authors.lastname: Pullman
authors.affiliation: Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA.|Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA.|Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA.
authors.forename: Elan D
authors.initials: ED
authors.lastname: Louis
mesh_terms: D004576:Electromyography; D020329:Essential Tremor / Q000150:complications* / Q000175:diagnosis; D005152:Facial Muscles / Q000503:physiopathology; D005546:Forehead / Q000503:physiopathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012720:Severity of Illness Index; D014202:Tremor / Q000150:complications* / Q000175:diagnosis / Q000503:physiopathology*; D014743:Videotape Recording