Unusual forehead tremor in a patient with essential tremor

Authors

  • Panida Piboolnurak MD,

    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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  • Seth L. Pullman MD,

    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
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  • Elan D. Louis MD, MS

    Corresponding author
    1. Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    2. Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    3. Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    • Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032
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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. © 2004 Movement Disorder Society

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