Klassifikation des Tremors

Zusammenfassung

Der Tremor gehört auch heute noch zu den Syndromen, die überwiegend anhand der klinischen Symptome diagnostiziert und eingeteilt werden. 1998 ist eine Klassifikation des Tremors erschienen, die innerhalb der Movement Disorder Society abgestimmt wurde. Die wesentlichen Grundbegriffe der Tremorsemiologie werden klinisch definiert und darauf baut dann die syndromatische Klassifikation des Tremors auf. Es werden folgende Tremorformen unterschieden: Verstärkter physiologischer Tremor, klassischer essenzieller Tremor, orthostatischer Tremor, aufgabenspezifischer Tremor, dystoner Tremor, Parkinson-Tremor, zerebellärer Tremor, Holmes-Tremor, medikamenten- oder toxininduzierter Tremor, neuropathischer Tremor und psychogener Tremor. Die Definitionen und wichtigsten diagnostischen Kriterien werden ausgeführt. Die relevanten Differenzialdiagnosen werden ebenfalls erläutert.

Abstract

Tremor is among the most common clinical syndromes and is classified on pure clinical criteria still nowadays. A major problem in the past has been, that no unified classification has been developed covering all the different etiologies of tremor. This has been achieved in 1998 by the Movement Disorder Society. The present paper is summarizing the definitions of this consensus-statement. Based on clinical criteria, the following tremors have been separated: Enhanced physiologic tremor, classical essential tremor, orthostatic tremor, task-specific tremor, dystonic tremor, Parkinsonian tremor, cerebellar tremor, Holmes' tremor, drug or toxin-induced tremor, neuropathic tremor and psychogenic tremor. The definitions are discussed and the most important differential diagnoses are specified.

Referenzen

• 1 Deuschl G, Bain P, Brin M. et al . Consensus statement of the Movement Disorder Society on Tremor.  Mov Disord. 1998;  13 2-23
• 2 Marsden C D. Origins of normal and pathologic tremor. In: Findley LJ, Capildeo R (eds) Movement Disorders: Tremor. London; Macmillan Press 1984: 37-84
• 3 Raethjen J, Pawlas F, Lindemann M. et al . Determinants of physiologic tremor in a large normal population.  Clin Neurophysiol. 2000;  111 1825-1837
• 4 Deuschl G, Raethjen J, Lindemann M. et al . The pathophysiology of tremor.  Muscle Nerve. 2001;  24 716-735
• 5 Findley L J, Koller W C. Essential tremor: a review.  Neurology. 1987;  37 1194-1197
• 6 Elble R J, Koller W C. Tremor. Baltimore, London; The Johns Hopkins University Press 1990
• 7 Bain P G, Findley L J, Thompson P D. et al . A study of hereditary essential tremor.  Brain. 1994;  117 805-824
• 8 Bain P, Brin M, Deuschl G. et al . Criteria for the diagnosis of essential tremor.  Neurology. 2000;  54 S7
• 9 Deuschl G, Wenzelburger R, Loffler K. et al . Essential tremor and cerebellar dysfunction clinical and kinematic analysis of intention tremor.  Brain. 2000;  123 1568-1580
• 10 Stolze H, Petersen G, Raethjen J. et al . The gait disorder of advanced essential tremor.  Brain. 2001;  124 2278-2286
• 11 Rothwell J C, Traub M M, Marsden C D. Primary writing tremor.  J Neurol Neurosurg Psychiatry. 1979;  42 1106-1114
• 12 Klawans H L, Glantz R, Tanner C M. et al . Primary writing tremor: a selective action tremor.  Neurology. 1982;  32 203-206
• 13 Elble R J, Moody C, Higgins C. Primary writing tremor. A form of focal dystonia?.  Mov Disord. 1990;  5 118-126
• 14 Bain P G, Findley L J, Britton T C. et al . Primary writing tremor.  Brain. 1995;  116 203-209
• 15 Jimenez-Jimenez F J, Cabrera-Valdivia F, Orti-Pareja M. et al . Bilateral primary writing tremor.  Eur J Neurol. 1998;  5 613-614
• 16 Hachinski V C, Thomsen I V, Buch N H. The nature of primary vocal tremor.  Can J Neurol Sci. 1975;  2 195-197
• 17 Findley L J, Gresty M A. Head, facial, and voice tremor.  Advances in Neurology. 1988;  49 239-253
• 18 Gamboa J, Jimenez-Jimenez F J, Nieto A. et al . Acoustic voice analysis in patients with essential tremor.  J Voice. 1998;  12 444-452
• 19 Hughes A J, Lees A J, Marsden C D. Paroxysmal dystonic head tremor.  Mov Disord. 1991;  6 85-86
• 20 Jankovic J, Schwartz K. Botulinum toxin treatment of tremors.  Neurology. 1991;  41 1185-1188
• 21 Jedynak C P, Bonnet A M, Agid Y. Tremor and idiopathic dystonia.  Mov Disord. 1991;  6 230-236
• 22 Deuschl G, Heinen F, Kleedorfer B. et al . Clinical and polymyographic investigation of spasmodic torticollis.  J Neurol. 1992;  239 9-15
• 23 Dubinsky R M, Gray C S, Koller W C. Essential tremor and dystonia.  Neurology. 1993;  43 2382-2384
• 24 Davis T L, Charles P D, Burns R S. Clonazepam-sensitive intermittent dystonic tremor.  South Med J. 1995;  88 1069-1071
• 25 Vidailhet M, Dupel C, Lehericy S. et al . Dopaminergic dysfunction in midbrain dystonia: anatomoclinical study using 3-dimensional magnetic resonance imaging and fluorodopa F18 positron emission tomography.  Arch Neurol. 1999;  56 982-989
• 26 Jedynak P C, Tranchant C, de Beyl D Z. Prospective clinical study of writer's cramp.  Mov Disord. 2001;  16 494-499
• 27 Hughes A J, Daniel S E, Kilford L. et al . Accuracy of clinical diagnosis of idiopathic Parkinson's disease: a clinico-pathological study of 100 cases.  J Neurol Neurosurg Psychiatry. 1992;  55 181-184
• 28 Brooks D J, Playford E D, Ibanez V. et al . Isolated tremor and disruption of the nigrostriatal dopaminergic system: an 18F-dopa PET study.  Neurology. 1992;  42 1554-1560
• 29 Hughes A J, Daniel S E, Blankson S. et al . A clinicopathologic study of 100 cases of Parkinson's disease.  Arch Neurol. 1993;  50 140-148
• 30 Quinn N P. Parkinson's disease: clinical features.  Baillieres Clin Neurol. 1997;  6 1-13
• 31 Hallett M. Overview of human tremor physiology.  Mov Disord. 1998;  13 43-48
• 32 Jankovic J, Schwartz K S, Ondo W. Re-emergent tremor of Parkinson's disease.  J Neurol Neurosurg Psychiatry. 1999;  67 646-650
• 33 Koller W C, Vetere O B, Barter R. Tremors in early Parkinson's disease.  Clin Neuropharmacol. 1989;  12 293-297
• 34 Holmes G. On certain tremors in organic cerebral lesions.  Brain. 1904;  27 327-375
• 35 Defer G L, Remy P, Malapert D. et al . Rest tremor and extrapyramidal symptoms after midbrain haemorrhage: clinical and 18F-dopa PET evaluation.  J Neurol Neurosurg Psychiatry. 1994;  57 987-989
• 36 Remy P, de Recondo A, Defer G. et al . Peduncular „rubral” tremor and dopaminergic denervation: a PET study (see comments).  Neurology. 1995;  45 472-477
• 37 Deuschl G, Wilms H, Krack P. et al . Function of the cerebellum in Parkinsonian rest tremor and Holmes' tremor.  Ann Neurol. 1999;  46 126-128
• 38 Deuschl G, Mischke G, Schenck E. et al . Symptomatic and essential rhythmic palatal myoclonus.  Brain. 1990;  113 1645-1672
• 39 Deuschl G, Toro C, Valls S J. et al . Symptomatic and essential palatal tremor. 1. Clinical, physiological and MRI analysis.  Brain. 1994;  117 775-788
• 40 Diener H C, Dichgans J. Pathophysiology of cerebellar ataxia.  Mov Disord. 1992;  7 95-109
• 41 Dalakas M C, Teravainen H, Engel W K. Tremor as a feature of chronic relapsing and dysgammaglobulinemic polyneuropathies. Incidence and management.  Arch Neurol. 1984;  41 711-714
• 42 Meier C, Steck A, Vandevelde M. Immunopathogenesis of polyneuropathies in paraproteinemia.  DMW. 1984;  109 828-833
• 43 Smith I S. The natural history of chronic demyelinating neuropathy associated with benign IgM paraproteinaemia. A clinical and neurophysiological study.  Brain. 1994;  117 949-957
• 44 Bain P G, Britton T C, Jenkins I H. et al . Tremor associated with benign IgM paraproteinaemic neuropathy.  Brain. 1996;  119 789-799
• 45 Kretschmer E. Die Gesetze der willkürlichen Reflexverstärkung in ihrer Bedeutung für das Hysterie- und Simulationsproblem.  Zsch ges Neurol und Psychiatrie. 1918;  41 354-385
• 46 Koller W, Lang A, Vetere O B. et al . Psychogenic tremors.  Neurology. 1989;  39 1094-1099
• 47 Deuschl G, Koster B, Lucking C H. et al . Diagnostic and pathophysiological aspects of psychogenic tremors.  Mov Disord. 1998;  13 294-302
• 48 Kim Y J, Pakiam A S, Lang A E. Historical and clinical features of psychogenic tremor: a review of 70 cases.  Can J Neurol Sci. 1999;  26 190-195
• 49 McAuley J H, Rothwell J C, Marsden C D. et al . Electrophysiological aids in distinguishing organic from psychogenic tremor.  Neurology. 1998;  50 1882-1884
• 50 Ikeda A, Kakigi R, Funai N. et al . Cortical tremor: a variant of cortical reflex myoclonus.  Neurology. 1990;  40 1561-1565
• 51 Toro C, Pascual L A, Deuschl G. et al . Cortical tremor. A common manifestation of cortical myoclonus.  Neurology. 1993;  43 2346-2353
• 52 Terada K, Ikeda A, Mima T. et al . Familial cortical myoclonic tremor as a unique form of cortical reflex myoclonus.  Mov Disord. 1997;  12 370-377
• 53 Elia M, Musumeci S A, Ferri R. et al . Familial cortical tremor, epilepsy, and mental retardation: a distinct clinical entity?.  Arch Neurol. 1998;  55 1569-1573
• 54 Okuma Y, Shimo Y, Shimura H. et al . Familial cortical tremor with epilepsy: an under-recognized familial tremor.  Clin Neurol Neurosurg. 1998;  100 75-78
• 55 Oguni E, Hayashi A, Ishii A. et al . A case of cortical tremor as a variant of cortical reflex myoclonus.  Eur Neurol. 1995;  35 63-64