Slide 1Resident and Fellow Section
A 77 year-old woman with Parkinson’s disease exhibits re-emergent jaw tremor.
© 2015 American Academy of Neurology
Vignette
A 77-year-old woman had levodopa/carbidopa-responsive akinesia in her left hand and was diagnosed with Parkinson’s disease at the age of 51 years.
For the previous 4 years she had jaw tremor, but no tremor in other parts of her body in off-phase.
The jaw tremor was noticeably reduced during voluntary movements, such as vocalization, and initially upon biting a tongue depressor.
However, the tremor reappeared after 10 seconds of continuous biting of the tongue depressor.
Hatano T et al.
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Video
© 2015 American Academy of Neurology
Video: Her jaw tremor was reduced during voluntary movements, such as vocalization and initially upon biting a tongue depressor. However, the tremor reappeared after 10 seconds of continuous biting. Levodopa/carbidopa treatment ameliorated her tremor. The re-emergent tremor generally has a similar frequency to that of resting tremor, and showed dopaminergic responsiveness.
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Re-emergent tremor in Parkinson’s disease
It is well known that one type of postural tremor in the forearms is a resting tremor that re-emerges after some delay while maintaining posture, namely “re-emergent tremor”. 1
The re-emergent tremor is considered to be a possible analog of the parkinsonian resting tremor.
The patient’s jaw tremor is a similar phenomenon to re-emergent tremors in the hands and forearms of PD patients.
Neurologists should be aware that re-emergent jaw tremor might a specific phenomenon in parkinsonian resting tremor.
Hatano T et al.
REFERENCES:
1) 1 Jankovic J., Schwartz K.S., Ondo W. Re-emergent tremor of Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999;67:646-650
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