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Movement Disorders Clinical Practice
Article . 2025 . Peer-reviewed
License: CC BY NC ND
Data sources: Crossref
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PubMed Central
Article . 2025
License: CC BY NC ND
Data sources: PubMed Central
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Functional Head Tremor: Contrasting Features with Other Tremor Etiologies

Authors: José Fidel Baizabal‐Carvallo; Joseph Jankovic;

Functional Head Tremor: Contrasting Features with Other Tremor Etiologies

Abstract

Abstract Background Functional tremor (FT) is considered the most common phenomenology among patients with functional movement disorders (FMDs). Most patients have limb tremor, but they can also present with tremor involving the head and trunk. Objectives and Methods We aimed to assess the clinical phenomenology of functional head tremor (FHT) and contrast it with features of HT observed in 125 patients with other tremor etiologies (OTE), including 71 patients with essential tremor (ET). Results There were 101 consecutive patients (68.3% females) with FT from which n = 36 (35.6%) had FHT. Yes‐yes tremor was the most common directionality (47.2%). Functional trunk tremor was identified in n = 20 (19.8%) patients with FT. Patients with FHT were older ( P < 0.05) and had greater FMDs severity with higher Simplified Functional Movement Disorders Rating Scale (S‐FMDRS) scores ( P < 0.001). When patients with FT were compared with those with OTE and ET, no differences were observed in the proportion of HT, but yes‐yes directionality and more severe HT was more common in those with FMDs. A change in HT directionality was more frequent in patients with functional etiology ( P = 0.007). This sign had high specificity (0.91) but low sensitivity (0.47) for the diagnosis of FHT. Comorbid trunk tremor had specificity of 0.89 and sensitivity of 0.28 to diagnose FHT. Conclusions HT is present in a third of patients with FT. These patients showed a grater severity of FMDs than FT without HT. A change in tremor directionality and comorbid trunk tremor had high specificity for the diagnosis for FHT compared with OTE.

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Keywords

Male, Aged, 80 and over, Adult, Essential Tremor, Middle Aged, Severity of Illness Index, Tremor, Humans, Female, Head, Research Article, Aged

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
1
Average
Average
Average
Green
hybrid