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Unilateral lower limb rest tremor is not necessarily a presenting symptom of Parkinson's disease

✍ Scribed by Mark A. Hellmann; Eldad Melamed; Adam P. Steinmetz; Ruth Djaldetti


Publisher
John Wiley and Sons
Year
2010
Tongue
English
Weight
488 KB
Volume
25
Category
Article
ISSN
0885-3185

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✦ Synopsis


Lower leg rest tremor is an uncommon symptom of neurological disease. Review of the files of 16 patients who presented with lower leg tremor (average age 58 +/- 16 years; average disease duration 6.8 +/- 8.5 years) yielded a diagnosis of Parkinson's disease (PD) in 5 and probable multiple system atrophy (MSA) in 3. In 4 patients with an indeterminate diagnosis, cardiac MIBG SPECT was positive in 3, indicating PD, and negative in one, suggesting MSA. Two patients each had psychogenic tremor and drug-induced parkinsonism. Although lower leg tremor is considered an unusual presentation of PD, it should raise suspicions of MSA and other neurodegenerative disorders.