Tremor and Other Hyperkinetic Movements最新文献

{"title":"Lip and Jaw Tremor in Parkinson's Disease.","authors":"José Fidel Baizabal-Carvallo, Marlene Alonso-Juarez, Robert Fekete","doi":"10.5334/tohm.1001","DOIUrl":"https://doi.org/10.5334/tohm.1001","url":null,"abstract":"<p><strong>Background: </strong>Parkinson's disease (PD) is characterized clinically by the presence of bradykinesia, rigidity, and tremor. Although upper limb rest tremor is the most common form of tremor in PD, lip/jaw tremor is identified in a proportion of these patients.</p><p><strong>Methods: </strong>We aimed to assess the frequency, features, and correlates of lip/jaw tremor in PD.</p><p><strong>Results: </strong>We studied 229 consecutive patients with PD. There were 39 (17%) patients with lip/jaw tremor, 22 of them (56.4%) were males. Slight lip/jaw tremor was identified in n = 10 (25.6%), mild in n = 15 (38.5%), moderate in n = 13 (33.3%) and severe in n = 1 (2.6%) case. Patients with lip/jaw tremor had a positive association with older age, greater limb rest tremor scores (<i>P</i> = 0.009), and higher total MDS-UPDRS-III scores (<i>P</i> < 0.001) in the multivariate regression analysis. There were 6 patients with isolated lip/jaw tremor (i.e. without limb rest tremor). These patients were all male (<i>P</i> = 0.038), tended to be older (75.7 vs. 67.7 years, <i>P</i> = 0.078) and had greater cognitive impairment (<i>P</i> = 0.034) than the rest of the cohort, but there was no association with other body tremors or total motor score.</p><p><strong>Conclusions: </strong>Lip/jaw tremor was identified in 17% of cases; it was associated with greater motor severity and limb rest tremor, suggesting shared pathophysiology with limb rest tremor. A subgroup with isolated lip/jaw tremor showed reduced cognitive performance, but no association with other body tremors.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"13"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005137/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144048105","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Double-Blind, Randomized, Placebo-Controlled, Crossover Study of Oral Cannabidiol and Tetrahydrocannabinol for Essential Tremor.","authors":"Katherine Longardner, Qian Shen, Francisco X Castellanos, Bin Tang, Rhea Gandhi, Brenton A Wright, Jeremiah D Momper, Fatta B Nahab","doi":"10.5334/tohm.1005","DOIUrl":"https://doi.org/10.5334/tohm.1005","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) is characterized by often disabling action tremors. No pharmacological agent has been developed specifically for symptomatic treatment. Anecdotal reports describe tremor improvement with cannabis, but no evidence exists to support these claims. We conducted a phase Ib/II double-blind, placebo-controlled, crossover pilot trial in participants with ET to investigate tolerability, safety, and efficacy of Tilray TN-CT120 LM, an oral pharmaceutical-grade formulation containing tetrahydrocannabinol (THC) 5 mg and cannabidiol (CBD) 100 mg. Our objectives were to determine if short-term THC/CBD exposure improved tremor amplitude and was tolerated.</p><p><strong>Methods: </strong>Participants with ET were randomized (1:1) to receive either TN-CT120 LM or placebo. Dose titration, driven by tolerability, was attempted every 2-3 days to three capsules daily maximum. Participants remained on the highest tolerated dose for two weeks before returning to complete assessments. After completing the first arm, participants titrated off the agent, underwent a three-week washout, and then returned for the same procedures with the alternate compound. The primary endpoint was tremor amplitude change from baseline using digital spiral assessment. Secondary endpoints explored safety and tolerability.</p><p><strong>Results: </strong>Among thirteen participants screened, seven were eligible and enrolled. Five completed all visits; one withdrew following a serious adverse event, and another did not tolerate the lowest dose. Intent-to-treat analyses performed for six participants did not reveal significant effects on primary or secondary endpoints.</p><p><strong>Conclusions: </strong>This pilot trial did not detect any signals of efficacy of THC/CBD in ET. Although preliminary due to the small sample size, our data do not support anecdotal reports of cannabinoid effectiveness for ET.</p><p><strong>Highlights: </strong>This double-blind, randomized, placebo-controlled efficacy and tolerability pilot trial did not detect any signals of efficacy of oral cannabidiol and tetrahydrocannabinol in reducing essential tremor amplitude using either digital outcome measures or clinical rating scales. The oral cannabinoids were well-tolerated by most (five out of seven) participants.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"14"},"PeriodicalIF":2.5,"publicationDate":"2025-04-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12005140/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144025292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Lesioning Through a Directional Deep Brain Stimulation Lead in the Subthalamic Nucleus.","authors":"Alfonso Enrique Martinez Nunez, Dorian M Kusyk, Joshua K Wong, Michael S Okun, Justin D Hilliard","doi":"10.5334/tohm.993","DOIUrl":"https://doi.org/10.5334/tohm.993","url":null,"abstract":"<p><strong>Clinical vignette: </strong>A 59-year-old woman with a previous subthalamic nucleus deep brain stimulation (DBS) implanted for Parkinson's disease developed a hardware related infection.</p><p><strong>Clinical dilemma: </strong>Wound dehiscence and infection developed and necessitated removal of the DBS system. The patient experienced excellent therapeutic benefit from her DBS and expressed concern about device removal.</p><p><strong>Clinical solution: </strong>The patient was offered the option of a lesioning procedure which could be performed during hardware explantation. An operative procedure was conducted where the intracranial DBS lead was connected to a radiofrequency system in a deliberate effort to create a targeted subthalamotomy through the existing DBS lead. A multilevel lesion was generated using the contacts on the directional DBS lead. Following the lesion the DBS lead and hardware were removed.</p><p><strong>Gap in knowledge: </strong>Creating a lesion through a DBS lead using radiofrequency ablation is a therapeutic option for patients not interested in later re-implantation or for those with a history of multiple DBS related infections. Lesioning through segmented leads introduces more complexity into the procedure.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"12"},"PeriodicalIF":2.5,"publicationDate":"2025-04-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11987846/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144038694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Myorhythmia: A Quantitative Study of Synchrony and Rhythmicity Between the Head and Upper Limbs.","authors":"Mahmoud Elkhooly, Ahmad Elkouzi, Rodger J Elble","doi":"10.5334/tohm.986","DOIUrl":"10.5334/tohm.986","url":null,"abstract":"<p><strong>Background: </strong>Myorhythmia is a <4 Hz oscillatory movement disorder that has been variably described as synchronous or asynchronous between body parts and as jerky or rhythmic in appearance, but there is no published report of quantitative motion analysis.</p><p><strong>Methods: </strong>A 51-year-old woman developed disabling myorhythmia in the head and upper limbs (right>left) approximately three months after a relapse of multiple sclerosis in her brainstem and cerebellum. Head and bilateral hand motion was recorded at rest and during posture with triaxial accelerometers and gyroscopic transducers. Recordings were analyzed with spectral power and coherence analyses. Frequency variability was quantified as half-power spectral bandwidth and interquartile range of cycle-to-cycle frequency change. Waveform deviation from sinusoidality was quantified as total harmonic distortion.</p><p><strong>Results: </strong>The 2.5-3.2 Hz head and hand oscillations exhibited narrow frequency bandwidths (≤0.21 Hz) and interquartile frequency changes (≤0.38 Hz). Amplitude fluctuated greatly, but head and hand oscillations were intermittently synchronous (coherence 0.8-1.0). Waveform was not perfectly sinusoidal and varied with the transducer.</p><p><strong>Conclusions: </strong>This is the first quantitative demonstration of very high rhythmicity and nearly perfect coherence of myorhythmia between different body parts, consistent with the classification of myorhythmia as a form of tremor. Limitations of the quantitative methods are discussed.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"9"},"PeriodicalIF":2.5,"publicationDate":"2025-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11967460/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143780292","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Associations Between Cognitive Profiles and Balance in Essential Tremor.","authors":"Nathan Hantke, Barbara H Brumbach, Lauren Siegel, Martina Mancini, Delaram Safarpour","doi":"10.5334/tohm.969","DOIUrl":"10.5334/tohm.969","url":null,"abstract":"<p><strong>Background: </strong>Essential Tremor (ET) is increasingly recognized as phenotypically heterogeneous disorder, which may encompass alterations in gait, balance and cognitive dysfunction. Disruption in cerebellar-thalamic-cortical circuits results in varying patterns of executive and memory dysfunction and balance disorders. The current study proposed two aims: 1) identify cognitive subtypes within individuals with essential tremor, and 2) examine for a correlation between these subtypes and gait and balance dysfunction. We hypothesize that gait and balance dysfunction are more common in individuals with ET who demonstrate greater cognitive difficulties.</p><p><strong>Methods: </strong>Seventy-one individuals underwent neuropsychological and physical therapy examinations as part of presurgical deep brain stimulation (DBS) evaluations that included measures of gait and balance (Mini-BESTest; Timed Up and Go, SARA). People with ET were categorized into Cognitively Normal (N = 29), Low Executive Function/Processing Speed (N = 17), and Low Memory Multi-domain groups (N = 25).</p><p><strong>Results: </strong>Regression analyses show that scores on the Mini-Balance Evaluation Systems Test and Scale for the Assessment and Rating of Ataxia were worse in the Low Memory and Low Executive Function groups compared to the cognitively normal group; age was also a significant predictor. Scores on the Timed Up and Go were worse for the Low Executive Function compared to the cognitive normal group; age and education were also significant predictors. Medication use was not associated with any of the clinical gait and balance tests. However, medication use and age were significant predictors of reported falls in daily life.</p><p><strong>Conclusions: </strong>A subset of individuals with ET experience cognitive dysfunction that coalesce into processing speed deficits or immediate memory deficits. These cognitive subtypes were associated with greater difficulty in balance and gait as compared to cognitively normal ET patient and this difference could not be accounted for by medications.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"9"},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927669/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693432","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pilot Study of AI-Controlled Transcutaneous Peripheral Nerve Stimulation for Essential Tremor.","authors":"Richard Dewey, Stuart Isaacson, Richard Dewey, Sagari Betté, Kelly E Lyons, Zhi Yang, Anh Tuan Nguyen, Qi Zhao, Zhen Zhang, Rajesh Pahwa","doi":"10.5334/tohm.991","DOIUrl":"10.5334/tohm.991","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) can impact daily activities and quality of life. Transcutaneous peripheral nerve stimulation (TPNS) modulates the central tremor network and can reduce tremor. We report a pilot study with a novel TPNS device.</p><p><strong>Methods: </strong>In this prospective, open-label study, ET patients underwent tremor evaluation and device fitting in the clinic, then used the system at home during waking hours for 7 to 10 days. Efficacy outcomes were the change from baseline to follow-up in The Essential Tremor Rating Assessment Scale (TETRAS) Performance Subscale (PS) for upper limbs, the TETRAS Activities of Daily Living (ADL) Subscale, the modified ADL (mADL) Score, and the Patient and Clinician Global Impression of Improvement questionnaires (PGI-I, CGI-I). Safety was also assessed.</p><p><strong>Results: </strong>In the 17 patients with evaluable data, the dominant-hand PS improved from 14.1 at baseline to 11.4 at follow-up (p = 0.0002); the ADL and mADL improved from 29.9 to 20.7 and 34.8 to 24.8, respectively (both p < 0.001). Improvement was reported for 82% of patients on both the PGI-I and CGI-I. A skin reaction in one patient with adhesive allergy was the only adverse event.</p><p><strong>Discussion: </strong>AI-controlled TPNS shows promise as a safe and effective treatment option for ET patients.</p><p><strong>Highlights: </strong>In an uncontrolled pilot study, an AI-controlled transcutaneous peripheral nerve stimulation device was worn continuously during waking hours for 7 to 10 days by patients with essential tremor. Tremor statistically significantly decreased as measured by TETRAS subscales and Global Impression of Improvement questionnaires, and side effects were negligible.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"10"},"PeriodicalIF":2.5,"publicationDate":"2025-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11927668/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143693381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ultrasound-Guided Botulinum Toxin Infiltrations in Essential Tremor Patients: A 36-week Follow Up.","authors":"Gabriel Salazar, Iolanda Caballero","doi":"10.5334/tohm.957","DOIUrl":"10.5334/tohm.957","url":null,"abstract":"<p><strong>Background: </strong>Essential tremor (ET) presents therapeutic challenges as oral therapies, are often partially effective and carry adverse effects. Deep Brain Stimulation and High-intensity Focused Ultrasound targeting the ventral intermediate thalamic nucleus show efficacy in managing ET; however, their cost and invasiveness deter some patients. Botulinum toxin infiltrations for ET in the upper limbs have been limited by adverse effects. Most studies used manual or electromyography guidance, while ultrasound guidance has been less explored. The purpose of the present study was to investigate the potential long-term improvement in tremor and quality of life among ET patients following ultrasound-guided IncobotulinumtoxinA (IncoBoNT) infiltrations.</p><p><strong>Methods: </strong>We present 18 ET patients who received IncoBoNT injections guided by ultrasounds. We also propose an anatomo-physiological paradigm for targeting muscles in ET patients based on two different tremor patterns.</p><p><strong>Results: </strong>Eighteen ET patients (mean age 68.2 years) were followed over 12 months. After 36 weeks, patients with supination/pronation (SPP) and flexion/extension (FEP) patterns showed significant TETRAS score improvements: 46.4% in SPP (p = 0.0022) and 48.2% in FEP (p = 0.0021). The QUEST-QOL score also improved (65% in SPP, p = 0.0018; 62.7% in FEP, p = 0.0018). All patients presented notable improvements in mean scores on the self-evaluating spiral test and neurophysiological measures (p < 0.01 for all). Treatment effects lasted 8-12 weeks, with temporary numbness and pain reported, and no cumulative effects observed.</p><p><strong>Discussion: </strong>Ultrasound-guided IncoBoNT infiltrations show promise for oral treatment-resistant ET patients with minimal adverse effects. The anatomophysiological paradigm utilized proved beneficial for our patients, although tremor pattern variability remains a consideration.</p><p><strong>Highlights: </strong>Essential tremor patients often face limited options, as oral therapies often yield only partial efficacy, and invasive interventions, like Deep Brain Stimulation, may not always be viable. In this open-label study, 18 patients received ultrasound-guided IncobotulinumtoxinA injections, showing significant tremor improvement and enhanced quality of life, with minimal adverse events reported.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"8"},"PeriodicalIF":2.5,"publicationDate":"2025-03-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11887461/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143587186","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Potential of Individual Upper-Limb Muscles to Contribute to Postural Tremor: Simulations From Neural Drive to Joint Rotation.","authors":"Spencer A Baker, Landon J Beutler, Daniel B Free, Dario Farina, Steven K Charles","doi":"10.5334/tohm.949","DOIUrl":"10.5334/tohm.949","url":null,"abstract":"<p><strong>Background: </strong>It is unclear which muscles contribute most to tremor and should therefore be targeted by tremor suppression methods. Previous studies used mathematical models to investigate how upper-limb biomechanics affect muscles' potential to generate tremor. These investigations yielded principles, but the models included at most only 15 muscles. Here we expand previous models to include 50 upper-limb muscles, simulate tremor propagation, and test the validity of the previously postulated principles.</p><p><strong>Methods: </strong>Tremor propagation was characterized using the gains between tremorogenic neural drive to the 50 muscles (inputs) and tremulous joint rotations in the 7 joint degrees-of-freedom (DOF) from shoulder to wrist (outputs). Each gain can be interpreted as the potential of a muscle to generate tremor in a DOF. Robustness and sensitivity analyses were performed to assess the effects of model parameter variability on gains.</p><p><strong>Results: </strong>Simulations of postural tremor using the expanded model confirmed the previously postulated principles and revealed new insights, including: 1) most of the muscles with the largest gains were among the 15 muscles in the original model; 2) some gains depended strongly on posture; 3) averaged across the postures included in this study, the largest gains belonged to input-output pairs involving biceps/forearm/wrist muscles and forearm/wrist DOF, 4) although some shoulder and extrinsic hand muscles also exhibited large gains, especially in select postures.</p><p><strong>Discussion: </strong>These observations suggest that in the absence of additional information (such as tremorogenic neural drive to muscles), peripheral tremor suppression efforts should start by targeting biceps/forearm/wrist muscles or forearm/wrist DOF.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"7"},"PeriodicalIF":2.5,"publicationDate":"2025-02-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11869822/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543431","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effectiveness of Spine Correction Belt for Treatment of Diaphragmatic Flutter.","authors":"Yoshiaki Kazama, Yuichi Ando, Masashi Suzuki, Juichi Sato","doi":"10.5334/tohm.967","DOIUrl":"10.5334/tohm.967","url":null,"abstract":"<p><strong>Background: </strong>Diaphragmatic flutter is an unusual movement disorder characterized by involuntary and repetitive contractions of the diaphragm. The pathophysiology is unclear. Its treatment is very difficult and challenging.</p><p><strong>Case report: </strong>A 70-year-old man presented with diaphragmatic flutter associated with severe abdominal pain in a sitting position, which stopped in a supine position. Videofluoroscopy clearly depicted diaphragmatic movements on postural change. A spine correction belt was effective for stopping diaphragmatic flutter.</p><p><strong>Discussion: </strong>This is the first reported case of diaphragmatic flutter for which a spine correction belt was used as successful and safe treatment.</p><p><strong>Highlights: </strong>Diaphragmatic flutter is an unusual movement disorder of the diaphragm. We describe a 70-year-old man who presented with diaphragmatic flutter associated with severe pain in a sitting position, which stopped in a supine position. A spine correction belt was used as successful and safe treatment for diaphragmatic flutter.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"6"},"PeriodicalIF":2.5,"publicationDate":"2025-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11827559/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143433739","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Progressive Choreiform Movements in a Child: Early Recognition and Management of Sydenham Chorea.","authors":"Jason M Jaronik, Nicholas A Scott, Bruce D Harley, Phillip L Marsh, Hassaan A Khan, Sufyan Zackariya, Anna M Tincher, Anthony V Thomas, Mahmoud D Al-Fadhl, John R Bales, Morgan C Lain, Uzma Rizvi, Randall J Bjork, Mark M Walsh","doi":"10.5334/tohm.988","DOIUrl":"10.5334/tohm.988","url":null,"abstract":"<p><strong>Background: </strong>Sydenham chorea, a rare neurological manifestation of acute rheumatic fever, persists in developed countries due to rheumatogenic strains of group A streptococcus.</p><p><strong>Phenomenology shown: </strong>This case demonstrates the evolution from subtle early symptoms to definitive severe choreiform movements in Sydenham chorea in a 10-year-old female.</p><p><strong>Educational value: </strong>This case highlights the importance of early recognition, multidisciplinary management, and vigilance in medication administration to optimize outcomes in rare conditions such as Sydenham chorea.</p><p><strong>Highlights: </strong>This case highlights the diagnostic and management challenges of Sydenham chorea, showcasing its progression from subtle early symptoms to definitive severe choreiform movements. It demonstrates the importance of early recognition, multidisciplinary care, and cautious medication administration to optimize outcomes in this rare neurological condition associated with rheumatic fever.</p>","PeriodicalId":23317,"journal":{"name":"Tremor and Other Hyperkinetic Movements","volume":"15 ","pages":"5"},"PeriodicalIF":2.5,"publicationDate":"2025-02-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11804171/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143383420","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}