The "prodromic" tremor: a new symptom of Parkinson's disease
In this article a new symptom of Parkinson disease is described: the "prodromic" tremor. This symptom consists of the description on the part of the patient or relatives of occasional tremor in one hand and the absence of this tremor during the neurological exploration made during the first visit to the specialist. That is, there is a discordance between what the patient or relatives explain and the one that finds the doctor.
One series of 7 patients with this symptom during a period of a year (prevalence of 2,7% of the patients that consult for tremor in this period) is presented. The time of beginning of the "prodròmic" tremor was brought an average of 9,5 weeks before the consultation. In three of these patients, in the neurological exploration other signs of Parkinson disease (rigidity, bradicinèsia) were found. After a clinical follow-up (average 24 weeks) all patients ended up fulfilling diagnostic criteria of idiopathic Parkinson disease.
In short, the description of a new symptom of the illness of Parkinson is presented. The "prodromic" tremor is a precocious symptom that turns up in the first stages of Parkinson disease, before the continous classical parkinsonian tremor. It is recommended a clinical follow-up of the patients with this symptom in spite of a normal neurological exploration in the first doctor visit.
References
Gironell A., Kulisevsky J., Pascual B., Pagonabarraga X. Movement Disorders 2007. 15: 1203-4.