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Tremor on smiling

Authors

  • Petra Schwingenschuh MD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL, Institute of Neurology, Queen Square, London, United Kingdom
    2. Medical University of Graz, Department of Neurology, Austria
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  • Carla Cordivari MD,

    1. Neurophysiology Department, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
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  • Julia Czerny MD,

    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL, Institute of Neurology, Queen Square, London, United Kingdom
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  • Marcello Esposito MD,

    1. Neurophysiology Department, The National Hospital for Neurology and Neurosurgery, Queen Square, London, United Kingdom
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  • Kailash P. Bhatia MD

    Corresponding author
    1. Sobell Department of Motor Neuroscience and Movement Disorders, UCL, Institute of Neurology, Queen Square, London, United Kingdom
    • Sobell Department, Institute of Neurology, UCL, Queen Square, London, UK, WC1N 3BG
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  • Potential conflict of interest: None reported.

Abstract

Facial tremor occurring on smiling is a rare phenomenon and has been described (to the best of our knowledge) in the literature only once. We describe two patients who presented with a bilateral facial tremor that occurred only on smiling and other activation of therisorii muscles and had a high frequency of 9 Hz. One patient additionally suffered from young-onset Parkinson's disease, whereas the other had no further neurological symptoms or signs apart from this tremor. Anti-parkinsonian medication was unhelpful for the facial tremor in the patient with Parkinson's disease. Tremor on smiling may be a discrete entity or may be associated in some cases of Parkinson's disease. © 2009 Movement Disorder Society

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