Abstract Details

Title The Clinical Role of Jaw Tremor in Movement Disorders

Topic Movement Disorders

Presentation(s) P14 - Poster Session 14 (8:00 AM-9:00 AM)

Poster/Presentation
Number 3-010

Objective

Determine the role of jaw/lip tremor in the clinical evaluation of movement disorders.

Background Jaw/lip tremor has been described in Essential Tremor (ET) as well as Parkinson’s Disease (PD) but studies assessing how jaw tremor impacts clinician diagnosis, and whether the presence of early jaw tremor is correlated with subsequent phenoconversion to a parkinsonian disorder are limited.

Design/Methods We used data from a longitudinal clinicopathological study (AZSAND). The control group included 709 subjects without jaw tremor, parkinsonism, or other tremor. Subjects with jaw tremor (n=276) were categorized as Isolated Jaw Tremor (without limb action tremor or parkinsonism), Suspect/Possible PD (one or two cardinal features of PD without a history of dopaminergic treatment), Parkinsonism-Other (Probable PD and atypical parkinsonisms), or Non-Parkinsonian Tremor (presence of limb action tremor or other non-parkinsonian tremor) based on initial clinical evaluation. Initial categorization was compared to “final diagnosis” based on longitudinal assessments. The neuropathological diagnoses were noted when available (n=137).

Results We identified 45 Isolated Jaw Tremor, 92 Non-Parkinsonian Tremor, 56 Suspect/Possible PD, and 83 Parkinsonism-Other cases. Mean time from initial to final assessment/autopsy was 5.9 years (SD 4.1). The majority of those with Isolated Jaw Tremor did not develop parkinsonism (33/39;84.6%) and remained categorized as Isolated Jaw Tremor; those with Non-Parkinsonian Tremor were primarily ET (49/69;71.0%), with 8.8% (6/68) evolving into a parkinsonism. Neither were associated with clinicopathologic PD: Isolated Jaw Tremor (1/18, OR 5.5 (95%CI: 0.7 to 41.9)) and Non-Parkinsonian Tremor (1/43, OR 2.1 (95% CI: 0.3 to 15.5)) compared to controls. Those with jaw tremor in a parkinsonian group were more highly associated with clinicopathologic PD: Parkinsonism-Other (27/51, OR 65.5 (95% CI: 16.8 to 255.5)) and Suspect/Possible PD (4/25, OR 15.8 (95% CI: 3.0 to 82.6)).

Conclusions The presence of jaw tremor in isolation or associated with limb action tremor does not portend a neurodegenerative diagnosis.

Authors/Disclosures
Sana Aslam, DO (University of Colorado) PRESENTER	Dr. Aslam has nothing to disclose.
Nan Zhang	Nan Zhang has nothing to disclose.
Charles H. Adler, MD, PhD, F�鶹��ýӳ�� (Mayo Clinic Arizona)	Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Amneal. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Avion. Dr. Adler has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CND Life Sci. Dr. Adler has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Jazz. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Precon. Dr. Adler has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Neurocrine. The institution of Dr. Adler has received research support from NIH. The institution of Dr. Adler has received research support from Michael J. Fox Foundation. The institution of Dr. Adler has received research support from Arizona Biomedical Research Commission. Dr. Adler has received publishing royalties from a publication relating to health care.
Shyamal Mehta, MD, PhD, F�鶹��ýӳ�� (Mayo Clinic, Arizona)	Dr. Mehta has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Adamas Pharma. Dr. Mehta has received personal compensation in the range of $5,000-$9,999 for serving as a Consultant for Abbott. Dr. Mehta has received personal compensation in the range of $10,000-$49,999 for serving as a Consultant for CNS Ratings.
Thomas Beach (Banner Sun Health Research Institute)	Thomas Beach has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Vivid Genomics. Thomas Beach has received personal compensation in the range of $500-$4,999 for serving on a Speakers Bureau for Roche Diagnostics. The institution of Thomas Beach has received research support from National Institutes of Health. The institution of Thomas Beach has received research support from Michael J Fox Foundation . The institution of Thomas Beach has received research support from State of Arizona.
Holly A. Shill, MD, F�鶹��ýӳ�� (Barrow Neurology Clinics)	Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Sage Biogen. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Abbvie. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for KeifeRx. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Praxis Precision Medicine. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Fasikl Inc. Dr. Shill has received personal compensation in the range of $0-$499 for serving as a Consultant for Boston Scientific. Dr. Shill has received personal compensation in the range of $500-$4,999 for serving as a Consultant for Mitsubishi Tanabe Pharma America.

�鶹��ýӳ��

�鶹��ýӳ��