ABSTRACT
BACKGROUND: There is growing study of the psychiatric features of essential tremor. Depressive symptoms occur in a considerable number of patients. Yet their impact, as a primary factor, has received almost no attention. We assessed whether, independent of tremor severity, patients with more depressive symptoms have more perceived tremor-related disability, lower tremor-related quality of life, and poorer compliance with tremor medication. METHODS: On the basis of their Center for Epidemiological Studies Depression Scale score, we stratified 70 essential tremor patients into three groups: 41 with minimal depressive symptoms, 24 with moderate depressive symptoms, and five with severe depressive symptoms. Importantly, the three groups had similar tremor severity on neurological examination. We assessed self-reported tremor-related disability, tremor-related quality of life (Quality of Life in Essential Tremor) (QUEST) score, and medication compliance. RESULTS: Cases with minimal depressive symptoms had the lowest QUEST scores (i.e., highest quality of life), cases with moderate depressive symptoms had intermediate scores, and those with severe depressive symptoms had the highest QUEST scores (i.e., lowest quality of life) (P < 0.001). Depressive symptoms were a stronger predictor of tremor-related quality of life than was the main motor feature of essential tremor (ET) itself (tremor). Self-reported medication compliance was lowest in cases with severe depressive symptoms and highest in cases with minimal depressive symptoms. CONCLUSIONS: The physical disability caused by the tremor of ET has traditionally been regarded as the most important feature of the disease that causes distress, and it has received the most attention in the management of patients with this disease. Our data indicate that this may not be the case.
Subject(s)
Depression/psychology , Essential Tremor/psychology , Medication Adherence/psychology , Quality of Life/psychology , Aged , Humans , Male , Psychiatric Status Rating ScalesABSTRACT
BACKGROUND AND PURPOSE: Patients with essential tremor (ET) and Parkinson's disease (PD) may exhibit overlapping clinical features. Also, a growing number of non-motor features are being documented in ET. Color vision abnormalities, although well known to occur in PD, have not been studied extensively in ET. We assessed color vision in ET cases and controls. We furthermore assessed subgroups of ET cases with clinical features that might link them to PD (i.e., ET cases with a family history of PD, and ET cases with rest tremor) to determine whether these cases had greater color vision abnormalities than ET cases without those features. METHODS: Participants were enrolled in a case-control study at Columbia University Medical Center. Color discrimination testing was performed using the Farnsworth-Munsell 100 Hue test. The total error score (TES) for the hue test was determined. RESULTS: The TES was similar in 55 ET cases and 55 controls (144.6 ± 91.8 vs. 145.6 ± 96.6, P = 0.96). ET cases with rest tremor (n = 8) were similar to ET cases without rest tremor (n = 47) with respect to the TES (117.0 ± 73.4 vs. 149.3 ± 94.4, P = 0.36), as were ET cases with a family history of PD (n = 9) versus without (n = 46) (144.4 ± 57.0 vs. 144.6 ± 97.6, P = 0.996). CONCLUSIONS: Although a number of links exist between ET and PD, and non-motor features have been described in both, a color vision abnormality does not seem to be a feature of ET.
Subject(s)
Color Vision , Essential Tremor/complications , Vision Disorders/epidemiology , Aged , Case-Control Studies , Female , Humans , MaleABSTRACT
1) Intal nebuliser solution can be effectively administered to young asthmatic children. 2) The treatment is well accepted and efficacious with no reported side effects. 3) Nebulisation provides a practical alternative for patients unable to inhale Intal powder via a spinhaler.
Subject(s)
Asthma/drug therapy , Cromolyn Sodium/therapeutic use , Aerosols , Child , Child, Preschool , HumansABSTRACT
Data from 1271 patients with perennial rhinitis has been assessed. This condition predominantly affects children and young adults; 31-5% stated that symptoms first appeared before the age of 10 years, less than 10% were aged 50 years or more suggesting that the disease process may well disappear in later life. The total sample size was equally divided between the sexes and the mean age for the sexes was similar. In terms of age distribution a sex difference was found in that the peak incidence for males occurred in the age group 10-19 years whereas for females it was in the third decade (P less than 0-001). The duration of the disease was, in most cases, between 2 and 9 years but it can extend to over 15 years and thus become subacute or chronic. The major symptom is blocking which could be due to either histological changes in the mucosa or immunological reactions. Skin tests showed that 64% had a positive reaction to common allergens; however, nasal challenge tests were of little value in determining whether a patient could be classified as allergic. Eosinophils were noted in 66%. The value of skin tests and nasal smears is discussed.
Subject(s)
Rhinitis, Allergic, Seasonal/immunology , Adolescent , Adult , Age Factors , Child , Female , Humans , Male , Middle Aged , Retrospective Studies , Skin TestsABSTRACT
Nineteen patients with perennial rhinitis were studied in a double blind crossover trial of 8 weeks duration using a 2% solution of sodium cromoglycate and placebo. Nasal smears, blood counts and serum IgE levels were carried out to determine whether any changes occurred with either the active or placebo formulations. Clinically, thirteen patients were greatly improved with the active solution, four showed no change and two became worse. Eosinophils in the nasal secretions were generally reduced during the administration of active solution but remained unchanged with the placebo.
