Ocular Tremor in Parkinson's Disease Is Due to Head Oscillation

Authors


  • Relevant conflicts of interest/financial disclosures: Nothing to report.

  • Full financial disclosures and author roles may be found in the online version of this article.

Correspondence to: Professor Adolfo M. Bronstein, Department of Neurosciences, Imperial College London, Charing Cross Hospital, London W6 8RF, UK; a.bronsein@imperial.ac.uk

ABSTRACT

Background

We investigated the origin of a recently reported ocular microtremor in patients with Parkinson's disease (PD).

Methods

Eye movements were recorded in 2 unselected patients with PD. Two recording techniques were used to control for artifacts: infrared video-oculography and infrared scleral reflection techniques. Head movements were also recorded with 2 different accelerometers.

Results

We recorded ocular oscillations in both patients (microtremor). Ocular tremor was accompanied by a recordable (but clinically nonvisible) head tremor of equal fundamental frequency and high coherence with both the eye oscillation and a recordable limb tremor. The eye movements were in the opposite direction to the head oscillation (ie, compensatory) and were suppressed by head restraint. There was no subjective oscillopsia, nor ocular tremor on fundoscopy.

Conclusions

The “ocular tremor” observed in patients with PD disease is a compensatory eye movement secondary to transmitted head tremor, in agreement with clinical wisdom that these patients do not report oscillopsia. © 2013 Movement Disorder Society

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