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Betel quid: Its tremor-producing effects in residents of Araihazar, Bangladesh

Authors

  • Danella Hafeman ScB,

    1. Mailman School of Public Health, Columbia University, New York, New York, USA
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  • Habibul Ahsan MMedSci, MD,

    1. Mailman School of Public Health, Columbia University, New York, New York, USA
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  • Tariqul Islam MBBS, MPH,

    1. Columbia University Arsenic Project, Araihazar, Bangladesh
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  • Elan Louis MS, MD

    Corresponding author
    1. Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, New York, USA
    2. Department of Neurology, 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

Betel quid consists of a betel nut (Areca catechu) and other additives. It is chewed throughout Asia and is the fourth most commonly used addictive substance in the world. Its stimulant properties are mediated by arecoline and other toxins. The neurological effects of betel quid use have not been studied extensively. To assess tremor, 100 residents of Araihazar, Bangladesh, were asked to draw spirals, which were rated by a blinded neurologist. The average tremor rating was 50% higher in exposed versus unexposed individuals. Betel quid use can produce clinically evident tremor. Population-based epidemiological studies of tremor in Asia should begin to take the effect of this stimulant into account. © 2005 Movement Disorder Society

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