Ataxic Gait in Essential Tremor: A Disease-Associated Feature?

Tremor and Other Hyperkinetic Movements

article

Ashwini K. Rao¹  Elan D. Louis² 

[1] Department of Rehabilitation & Regenerative Medicine (Program in Physical Therapy), G.H. Sergievsky Center, Huntington's Disease Center of Excellence, Center of Excellence in Alzheimer's Disease, Columbia University;Department of Neurology and Epidemiology (Chronic Diseases);Division of Movement Disorders, Co-Director- Center for Neuroepidemiology and Clinical Neurology Research

关键词: Essential tremor;    mobility;    gait;    balance;    posture;    ataxia;   

DOI  :  10.5334/tohm.507

学科分类：社会科学、人文和艺术（综合）

来源: Ubiquity Press

【 摘 要 】

Background: While accumulating evidence suggests that balance and gait impairments are commonly seen in patients with essential tremor (ET), questions remain regarding their prevalence, their relationship with normal aging, whether they are similar to the impairments seen in spinocerebellar ataxias, their functional consequences, and whether some ET patients carry greater susceptibility. Methods: We conducted a literature search (until December 2018) on this topic. Results: We identified 23 articles on gait or balance impairments in ET. The prevalence of balance impairment (missteps on tandem walk test) was seven times higher in ET patients than controls. Gait impairments in ET included reduced speed, increased asymmetry, and impaired dynamic balance. While balance and gait problems worsened with age, ET patients were more impaired than controls, independent of age. The pattern of impairments seen in ET was qualitatively similar to that seen in spinocerebellar ataxias. Balance and gait impairments resulted in greater number of near falls in ET patients. Factors associated with balance and gait impairments in ET included age, presence of tremor in midline structures, and cognitive dysfunction. Discussion: Accumulating evidence suggests that balance and gait impairments are common in ET patients and occur to a greater extent in controls. Thus, they represent a disease-associated feature. These impairments, which are qualitatively similar to those seen in spinocerebellar ataxias, are not merely subclinical but result in difficulty performing functional tasks and increase falls risk. A subset of patients is more susceptible to balance and gait impairments. The full spectrum of impairments remains to be characterized.

【 授权许可】

CC BY