To study prevalence, specific patterns and response to treatment of
tremor in
dementia with Lewy bodies (DLB), in comparison with other tremulous disorders prevalence, qualitative and quantitative features of
tremor were studied in an incident cohort of 67 dopaminergic treatment naive DLB, 111
Parkinson's Disease (PD) and 34
Essential Tremor (ET) patients. Tremulous DLB patients (tDLB) were compared with tremulous PD (tPD) and ET patients and followed for 2 years. Double blind placebo-controlled acute
drug challenge with
L-Dopa and alcohol was performed in all ET, 24 tDLB and 27 tPD. Effects of dopaminergic chronic treatment in all tDLB and tPD patients and
primidone in 8 tDLB were also assessed.
Tremor occurred in 44.76 % of DLB patients. The tDLB patients presented a complex pattern of mixed
tremors, characterized by rest and postural/
action tremor, including walking
tremor and standing overflow in 50 % tDLB. Standing
tremor with overflow was characteristic of tDLB (p < 0.001). Head
tremor was more frequent in tDLB than tPD and ET (p = 0.001). The tDLB
tremors were reduced by acute and chronic dopaminergic treatments (p < 0.01) but not by alcohol or
primidone.
Tremor occurs commonly in DLB patients with a complex mixed
tremor pattern which shows a significant response to acute and chronic dopaminergic treatments. Recognizing that there is a clinical category of tremulous DLB may help the differential diagnosis of
tremors.