The features and associated factors of tremor in patients with epilepsy / 中华神经科杂志

ABSTRACT

Objective:To investigate the clinical and electrophysiological characteristics of tremor in patients with epilepsy, and explore the related factors affecting the occurrence of tremor.Methods:A cross-sectional survey was conducted to collect 80 patients with epilepsy in the Department of Neurology, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine from September 2018 to September 2019. Patients were divided into tremor group and non-tremor group according to clinical evaluation. All patients with epilepsy were evaluated by the Clinical Rating Scale for Tremor and were examined by electromyography (EMG).Results:There were 22 (27.5%, 22/80) patients who were found with tremor by self-reported complaint and (or) physical examination by clinicians, mainly manifested as postural tremor in the upper limbs, and 7.5% (6/80) patients also showed resting tremor. The EMG examination revealed that 51 patients (63.8%, 51/80) had tremor in the upper limbs. The incidence was 2.3 times as much as clinical evaluation. Among them, 42 patients (82.3%, 42/51) manifested postural tremor in upper limbs, 32 patients (62.7%, 32/51) manifested resting tremor. The peak frequency of postural tremor was (7.2±4.1) Hz, and synchronous burst pattern was mainly showed. The peak frequency of resting tremor was (5.3±2.2) Hz, and alternating burst pattern was mainly showed. Multivariate analysis showed that large number of medications and long duration of taking valproate acid were significantly related to the occurrence of tremor in patients with epilepsy.Conclusions:Tremor is mainly manifested as postural tremor in the upper limbs in patients with epilepsy. The EMG is a more sensitive and objective examination, which can detect tremor that was not yet noticed. Large number of medications and long duration of taking valproate acid might be the mainly associated factors for occurrence of tremor in patients with epilepsy.