What are the 5 key features of dystonic tremor?

Teaching Video NeuroImages: The signs of dystonic tremor: tremulous “escanciador”.

Sharma J, Macias-Garcia D, Zaidi A, Espay AJ

Neurology 2018; 91:e1204-e1205.

A 58-year-old woman noticed right-hand jerky tremor exclusively while curling her hair. Her tremor-generating posture was reminiscent of the Asturian pourer of cider, or “escanciador,” who holds the bottle above the head when vertically pouring to aerate the liquid. On examination, we asked her to hold a water bottle as if it were a hair curler. This elicited an action-induced, position-dependent, task-specific, weight-sensitive tremor, which attenuated when touching her affected hand with the unaffected one (closed-loop sensory feedback or sensory trick). The rest of the examination was normal. These 5 clinical features distinguish dystonic tremor from all other tremor syndromes.

This paper is cited in the neurochecklist:

Dystonic tremor

Paper link

A twisted family tradition. Elisabeth Feldman on Flikr. https://www.flickr.com/photos/hurleygurley/4338767

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