Volume 22, Issue 15 p. 2210-2215
Research Article

Patients with adult-onset dystonic tremor resembling parkinsonian tremor have scans without evidence of dopaminergic deficit (SWEDDs)

Susanne A. Schneider MD

Susanne A. Schneider MD

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom

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Mark J. Edwards MD

Mark J. Edwards MD

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom

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Pablo Mir MD

Pablo Mir MD

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom

Servicio de Neurología, Hospital Universitario Virgen del Rocío, Seville, Spain

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Carla Cordivari MD

Carla Cordivari MD

The National Hospital for Neurology and Neurosurgery, Neurophysiology Department, Queen Square, London, United Kingdom

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Juzar Hooker MD

Juzar Hooker MD

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom

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John Dickson PhD

John Dickson PhD

Institute of Nuclear Medicine, UCL, London, United Kingdom

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Niall Quinn MD

Niall Quinn MD

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom

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Kailash P. Bhatia MD

Corresponding Author

Kailash P. Bhatia MD

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College London, Queen Square, London WC1N 3BG, United Kingdom

Sobell Department of Motor Neuroscience and Movement Disorders, Institute of Neurology, University College of London, Queen Square, London WC1N 3BG, United KingdomSearch for more papers by this author
First published: 21 August 2007
Citations: 191

Abstract

We present the clinical details and dopamine transporter SPECT scan results of 10 patients with arm tremor, including a rest component and reduced arm swing on the affected side, in whom the possibility of PD had been raised. All patients had signs of dystonia or components of their arm tremor that were compatible with dystonic tremor, and none had true akinesia with fatiguing or decrement, even after a mean follow-up period of 5.8 years. All patients had normal dopamine transporter SPECT scans. Clinicians should be aware that primary adult-onset dystonia can present with an asymmetric resting arm tremor, with impaired arm swing and sometimes also facial hypomimia or a jaw tremor, but without evidence of true akinesia. Given the important consequences of misdiagnosing such patients as PD, in cases with diagnostic uncertainty functional imaging should be considered. Among patients suspected of PD, dystonic tremor may be one cause of SWEDDs (Scans Without Evidence of Dopaminergic Deficit). © 2007 Movement Disorder Society