Pathophysiology of nonparkinsonian tremors

Güther Deuschl*, Hagai Bergman

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

149 Scopus citations

Abstract

Patients with nonparkinsonian tremors are the second largest group treated with functional neurosurgery. We summarize the present pathophysiological knowledge of these conditions. Essential tremor (ET) may be due to oscillations within the olivocerebellar circuit. There is experimental evidence from animal models for such a mechanism, and clinical data indicate an abnormal function of the cerebellum in ET. Cerebellar tremor may be closely related to the tremor seen in advanced ET. The malfunction of the cerebellum causes a pathological feed-forward control. Additionally an oscillator within the cerebellum or its input/output pathways may cause cerebellar tremor. Almost nothing is known about the pathophysiology of dystonic tremor. Holmes tremor is based on a nigral and a cerebellar malfunction and presents clinically as the combination of tremor in Parkinson's disease and cerebellar tremor. Neuropathic tremor can be extremely disabling and is thought to be due to an abnormal interaction of the disturbances within the periphery and abnormal cerebellar feedback. Unlike the case of Parkinson's disease, functional neurosurgery of nonparkinsonian tremors is not yet based on a solid pathophysiological background.

Original languageAmerican English
Pages (from-to)S41-S48
JournalMovement Disorders
Volume17
Issue numberSUPPL. 3
DOIs
StatePublished - 2002

Keywords

  • Cerebellar tremor
  • Deep-brain stimulation
  • Dystonic tremor
  • Essential tremor
  • Holmes tremor
  • Neuropathic tremor
  • Orthostatic tremor
  • Pathophysiology

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