Action tremor of the legs in essential tremor: Prevalence, clinical correlates, and comparison with age-matched controls

Poston, Kathleen L.; Rios, Eileen; Louis, Elan D.

doi:10.1016/j.parkreldis.2008.11.006

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Volume 15, Issue 8 , Pages 602-605, September 2009

Action tremor of the legs in essential tremor: Prevalence, clinical correlates, and comparison with age-matched controls

Kathleen L. Poston
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
Eileen Rios
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
Elan D. Louis
- Department of Neurology, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Gertrude H. Sergievsky Center, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Taub Institute for Research on Alzheimer's Disease and the Aging Brain, College of Physicians and Surgeons, Columbia University, New York, NY, USA
- Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA
- Correspondence to: Dr. Elan D. Louis, Unit 198, Neurological Institute, 710 West 168th Street, New York, NY 10032, USA. Tel.: +1 212 305 9194; fax: +1 212 305 1304.

Received 13 August 2008; received in revised form 15 October 2008; accepted 19 November 2008.

Abstract

The hallmark feature of essential tremor (ET) is action tremor of the arms. Leg tremor may also occur yet it has not been the central focus of previous studies. Its prevalence has only rarely been reported, its clinical correlates have yet to be explored. Our aims were to report the prevalence and analyze the clinical correlates of leg action tremor in patients with ET and, given the propensity for normal elderly individuals to manifest mild limb tremors, compare the prevalence with that in age-matched controls. Kinetic leg tremor rated ≥1 occurred in 28/63 (44.4%) ET cases and in only 9/63 (14.3%) controls (p<0.001); moderate leg tremor occurred in 14.3% of cases. Leg tremor severity modestly correlated with disease duration (r=0.31, p=0.02). However, the severity and laterality of leg tremor did not correlate with those of arm tremor. The pathophysiological implications of this finding deserve further exploration.