Navegando por Palavras-chave "tremor essencial"
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- ItemSomente MetadadadosComparação do uso da toxina botulínica e propranolol em pacientes com tremor vocal essencial e distônico(Universidade Federal de São Paulo (UNIFESP), 2013-10-21) Cruz, Grazzia Guglielmino da [UNIFESP]; Biase, Noemi Grigoletto de Biase [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)Background: The vocal tremor produces a lot of discomfort and commitment in sociability in these patients. The vocal tremors are classified, in any body part, in resting tremor and action tremor. Among the action tremor thatcommits the voice, the essential is the most common and it is related with the attitude. The rarer seems to be the dystonic vocal tremor that is related with especific tasks. Botulinum toxin and oral medications have been used to vocal tremor, but with no comparative clinical trials. Purpose: The aim of this study was to verify and to compare the treatment responses of intramuscular application of botulinum toxin and the oral use of propranolol in essential vocal tremor and dystonic vocal tremor. Method: Clinical trial. This research was performed with fifteen patients with vocal tremor selected in two groups: essential vocal tremor and dystonic vocal tremor. After both groups had been treated with botulinum toxin and propranolol in distinct periods and randomly, they underwent by self assessment, flexible nasolaryngoscopy evaluation and perceptual, hearing and acoustic voice evaluation. Statistical analysis was performed with 0,05 (5%) rate of significance. Results: There were statistically significant improvement in the perceptual and hearing measures of vocal instability of dystonic vocal tremor after botulinum toxin application comparing with propranolol and the pretreatment. The acoustic measure variability in fundamental frequency proved to be reliable with significant decrease in dystonic vocal tremor with botulinum toxin comparing with propranolol and the pretreatment also. The flexible nasolaryngoscopy evaluation proved to be applicable parameter post treatment with botulinum toxin in dystonic vocal tremor patients. Conclusions: Essential vocal tremor and dystonic vocal tremor differ in responses to treatments. Dystonic vocal tremor responds significantly to botulinum toxin application, but not to propranolol oral use. The essential tremor does not respond significantly to any treatment described before.
- ItemAcesso aberto (Open Access)Estimulação cerebral contínua (DBS) talâmica para controle do tremor(Academia Brasileira de Neurologia - ABNEURO, 2002-06-01) Nasser, José Augusto [UNIFESP]; Falavigna, Asdrubal; Alaminos, Armando; Bonatelli, Antônio De Pádua [UNIFESP]; Ferraz, Fernando [UNIFESP]; Hospital Pró-Cardíaco Serviço de Neurocirurgia; Estereolife, Neurocirurgia Funcional e Estereotáxica; Universidade Estácio de Sá Instituto Neurológico Estácio de Sá Instituto do Sono; Universidade Federal de São Paulo (UNIFESP)PURPOSE: We present our results in 4 patients with tremor, in whom electrodes (uni and bilateral) for Deep Brain Stimulation (DBS) were implanted in the ventral intermediate nucleus (VIM) of the thalamus. METHOD: Four patients with disabling tremor, with drug-resistant spite of optimum therapeutic trials with poor response were referred to do surgery. Two patients had bilateral essential tremor. These patients were implanted with electrodes for DBS 3387 (Medtronic). Two patients had unilateral parkinsonian tremor and they received unilateral implantation of model 3387 DBS. RESULTS: All four patients showed relieve of the tremor symptoms with significant tremor control seen at the scores. There were no definite adverse events after the electrodes implants for DBS; adverse events were transient and promptly reversed after the adjustment of the parameters. CONCLUSIONS: The results the authors found in this study indicate that VIM-stimulation is effective for tremor control either parkinsonian or essential tremor. The results correlate with the data in the literature.
- ItemAcesso aberto (Open Access)Tremor essencial: caracterização clínica de uma amostra de 176 pacientes(Academia Brasileira de Neurologia - ABNEURO, 1994-06-01) Borges, Vanderci [UNIFESP]; Ferraz, Henrique Ballalai [UNIFESP]; Andrade, Luiz Augusto Franco de [UNIFESP]; Universidade Federal de São Paulo (UNIFESP)We reviewed the clinical records of 176 patients with essential tremor (ET) according to sex, age of onset, family history, tremor characteristics and body distribution. The patients were divided into two groups: familial (F) and non familial (NF). A positive family history for tremor was observed in 47,2% of the patients. Action and postural tremor were the most frequent characteristic (49,4%), postural alone in 26,7% and action alone in 9,1%. Rest tremor was recorded in 10,2%, always associated with other characteristics. There were no clinical differences between the F and NF groups. Hands were involved in 94,9% and the head in 26,5%. Isolated tremor of the hands was the most frequent form of presentation with some greater frequency in males. Sixty per cent of the patients who presented head tremor either isolated or not, were females. The presence or absence of family history did not show difference in this proportion. The age of onset ranged between 4 and 85 years. In the F group a lower mean of onset (36,5 years) was seen in males with statistical significance. In male patients with combined action and postural tremor a lower age of onset was found. The fact of a patient having either parent affected by ET produced no difference in the age of onset. Familial or non familial ET bearing some differences, may not be considered as distinct entities.
- ItemAcesso aberto (Open Access)Tremor essencial: observações clínicas(Academia Brasileira de Neurologia - ABNEURO, 1993-09-01) Pereira, João S. [UNIFESP]; Pimentel, Maria Lúcia V.; Nicaretta, Denise H.; Universidade Federal de São Paulo (UNIFESP); Universidade do Estado do Rio de Janeiro Hospital Universitário Pedro Ernesto Ambulatório de Distúrbios do MovimentoThe authors have studied 53 patients with essential tremor, focusing its clinical and epidemiological aspects. There were familial history in 37.70% of all cases, prevailing in females (56.60%) and white people (69.80%); nevertheless this difference can not be assured from the statistical point of view due to lack of population data. We agreed that the main incidence of this syndrome occurred beyond the 5th decade, specially during the 6th and 7th decades. Topographically, we could observe that the hand tremor predominated, with an incidence of 96.20% of the total number of cases, followed by head tremor (28.30%), voice tremor (16.99%), leg tremor (11.30%), tongue tremor (3.78%) and trunk tremor (1.88%). These focal tremors were seldom observed alone and we noted frequent association with hand tremor.