Abstract
We describe the presenting features and long‐term outcomes of patients with electrophysiologically‐confirmed psychogenic tremor. Clinical information for all patients with psychogenic tremor confirmed by our Movement Disorders Neurophysiology Laboratory (2003–2004) was reviewed. A follow‐up questionnaire was administered to all included patients in 2007. Psychogenic tremor was documented in 62 patients; 33 responded to the questionnaire (53%). Median onset‐age was 50 years (range, 15–71); 23 were female (70%). Clinical certainty of psychogenic etiology was: definite, 8 (24%); probable, 16 (49%), and possible, 9 (27%). Characteristic electrodiagnostic features of psychogenic tremor were documented in all. All but two patients were ultimately given a definite diagnosis of psychogenic tremor; recommended psychiatric consultation was only done by 12 (36%). Twenty‐one patients (64%) rated tremor disability as moderate or severe after a median follow‐up of 5.1 years (range, 3.3–19). Improvement occurred spontaneously in 5 (15%), and after a specific intervention in 4 (12%), whereas 3 (9%) had mild but unchanged symptoms. The mean duration of symptoms, prior to diagnosis with psychogenic tremor, was significantly shorter for patients with mild or no tremor at follow‐up (P = 0.037). Physiologically‐confirmed psychogenic tremor carries a poor prognosis, with unremitting or worse tremor persisting 3‐years after diagnosis in most. © 2008 Movement Disorder Society