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Distinguishing features between valproate‐induced tremor and essential tremor
Author(s) -
AlonsoJuarez M.,
BaizabalCarvallo J. F.
Publication year - 2018
Publication title -
acta neurologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.967
H-Index - 95
eISSN - 1600-0404
pISSN - 0001-6314
DOI - 10.1111/ane.12953
Subject(s) - essential tremor , rating scale , medicine , physical medicine and rehabilitation , psychology , anesthesia , pediatrics , developmental psychology
Background Tremor frequently occurs in patients taking valproate and may resemble that observed in patients with essential tremor ( ET ). We aimed to compare the distribution, severity, and functional impact of both types of tremor. Methods Among 118 consecutive individuals taking valproate, we identified 28 patients with valproate‐induced tremor severe enough to require pharmacological treatment; through evaluations using the Clinical Rating Scale for Tremor ( CRST ), they were compared with 29 consecutive patients with ET . Results Patients with valproate‐induced tremor were significantly younger than those with ET : 35.6 ± 15.4 vs 58.8 ± 20.5 years ( P < .001), with a shorter evolution time of tremor ( P < .001). Total CRST scores did not differ between groups ( P = .164), neither in subscores of Parts A ( P = .321), B ( P = .094), and C ( P = .386). Patients with valproate‐induced tremor had a higher proportion of postural tongue tremor compared with ET patients: 22 (79%) vs 15 (52%) ( P = .034). A frank tremor axis in the Archimedes spirals was observed in a higher proportion of patients with ET compared to valproate‐induced tremor: 31% vs 3.6% ( P = .006). Conclusions Patients with valproate‐induced tremor requiring pharmacological treatment have similar distribution, CRST scores, and functional impact than those with ET .