Journal
CEREBELLUM
Volume 18, Issue 3, Pages 565-574Publisher
SPRINGER
DOI: 10.1007/s12311-018-0994-6
Keywords
Tremor; Cerebellar tremor; Intention tremor; Postural tremor; Kinetic tremor; Rest tremor
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Funding
- National Institutes of Health: NINDS [R01 NS094607, R01 NS073872, R01 NS086736, R01 NS085136, R01 NS088257]
- Claire O'Neil Essential Tremor Research Fund (Yale University)
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Tremor is an involuntary, rhythmic, oscillatory movement of a body part. It is a central feature of a range of diseases resulting from pathological changes in the cerebellum. Interestingly, in modern times, the terms cerebellar tremor and intention tremor are often used synonymously and interchangeably. However, cerebellar tremor (i.e., tremors of cerebellar origin) do not always present exclusively as intention tremor. In this article, we comprehensively revisit the clinical phenomenology of tremors observed in various diseases that are based in the cerebellum. By this, we mean diseases for which the cerebellum and its various connections are often seen as playing a central and defining role. These include spinocerebellar ataxias, essential tremor, orthostatic tremor, dystonia, acute cerebellitis, cerebellar tumors, paraneoplastic cerebellar degeneration, and cerebellar strokes. The theme of this article is to highlight, through published data available in the current literature, that the clinical phenomenology of tremor of cerebellar origin is heterogeneous, and it extends beyond that of intention tremor to include postural tremors, kinetic tremor, rest tremor, and orthostatic tremor. This heterogeneity is consistent with the seminal work of Gordon Holmes, in which he described a variety of tremors aside from intention tremor in the setting of cerebellar lesions. In the end, it would seem that the notion that intention tremor is the sole signature of cerebellar lesions is an over-simplification and is not correct. Future studies are warranted to identify and further characterize the heterogeneity of tremors arising from the various cerebellar etiologies.
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