Laryngeal tremor: co-occurrence with other movement disorders.

INTRODUCTION: Limited epidemiologic information exists regarding the co-occurrence of laryngeal tremor (LT) and tremor in other parts of the body, and of other movement disorders. Tremor is the involuntary skeletal muscle contraction that leads to oscillatory movement. It can affect many parts of the body including the chin, neck, laryngeal muscles, or limbs. When it is not associated with parkinsonism, it is called an essential tremor. We reviewed our 5-year experience with LT patients and the presence of other movement disorders. METHODS: We performed a retrospective review of 29 patients with LT seen in a voice clinic over a 5-year period from January 2004 to April 2009. RESULTS: Of the 29 patients, 27 (93%) had co-incidence of another movement disorder. Of these patients, 45% had spasmodic dysphonia, 41% had oropharyngeal tremors, 38% had essential limb tremor, 31% had orofacial dystonias, and 24% had essential head and neck tremor. Only 1 patient (3%) presented with Parkinson's disease. CONCLUSION: Otolaryngologists may be the first to evaluate a patient for tremors. It is important to consider other movement disorders when examining these patients as neurologic assessment and treatment of other tremors may be beneficial.

Prolonged T*2 values in newborn versus adult brain: Implications for fMRI studies of newborns.

The neonatal brain possesses higher water content, lower macromolecular concentration, and reduced synaptic density than is found in the brain of a 1-year-old child. Changes in MRI characteristics of brain such as relaxation times accompany rapid changes in brain during early postnatal development. It was hypothesized that T(*)(2) values found in newborns would be significantly higher than those found in 9-month-old children and adults as measured at 1.5 T. Spoiled gradient echo measurements of T(*)(2) within the brains of newborns, 9-month-olds, and adults confirmed this hypothesis. The results have implications with regard to functional MRI studies in newborns since, in general, BOLD signal optimization is achieved when echo times TE are set equal to the T(*)(2) values of the tissue of interest. Since significantly longer T(*)(2) values are found in newborns, it is suggested that the TE values employed for fMRI studies of newborns should be increased to maximize BOLD signal intensity changes and improve the overall reliability of fMRI results in newborns.