Co-occurrence of essential tremor and Parkinson's disease: Clinical study of a large kindred with autopsy findings

M. D. Yahr, D. Orosz, D. P. Purohit

Research output: Contribution to journalArticlepeer-review

73 Scopus citations

Abstract

A multigenerational family complex with an admixture of essential tremor (ET) and PD is presented. Medical information obtained either by historic documentation and/or examination was available for five generations and included 36 members. Of these, 11 family members had tremor of the limbs and/or head. In all these instances ET made its first appearance at an early age, usually prior to the second decade of life. In one case focal dystonia of the hand, a possible prelude to PD occurred, while in three brothers of the third generation, two of them identical twins, classical Parkinson's disease (PD) developed. They had ET develop at an early age, which persisted and in their 50s began showing evidence of PD. Two decades later the twin brothers succumbed to cancer of the colon and at autopsy typical findings of PD with cell loss in the substantia nigra and Lewy-body formation positive for α-synuclein by immunohistochemistry was found. Additionally, more than the usual number of senile plaques and neurofibrillatory tangles were present without clinical evidence of dementia or significant decline in cognitive function. This unusual set of clinical and pathological circumstances can hardly be attributed to chance occurrence and raise the question of a specific genetic mutation and/or clustering, which may link ET with PD.

Original languageEnglish
Pages (from-to)225-231
Number of pages7
JournalParkinsonism and Related Disorders
Volume9
Issue number4
DOIs
StatePublished - Mar 2003
Externally publishedYes

Keywords

  • Alpha-synuclein
  • Essential tremor
  • Family study
  • Lewy bodies
  • Parkinson's disease
  • Substantia nigra

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