Video 1
Three ET Patients with Progressively Worse Tremor.
Patient 1. This right-handed woman was 58 years old at baseline. There were five videotaped neurological examinations (T1 – T5). At T1 and T2, she was taking primidone (1,500 mg daily) and propranolol (160 mg daily). She underwent bilateral deep brain thalamic stimulation (DBS) surgery in 2015 and stopped her tremor medications at that point; the stimulator was turned off during the T3, T4, and T5 evaluations. The tremor ratings for certain movement tasks are listed in Table 1. During the wing beat position, there is mild dystonic posturing of the thumb at T4 (right) and T5 (left).
Patient 2. This right-handed woman was 66 years old at baseline. There were five videotaped neurological examinations (T1 – T5). The tremor ratings for certain movement tasks are shown in Table 1.
Patient 3. This right-handed woman was 66 years old at baseline. There were three videotaped neurological examinations (T1 – T3). At T1, T2, and T3, she was taking primidone (150 mg daily) and pindolol (10 mg daily). She had two bilateral DBS surgeries in 2007 and 2009. The tremor ratings are shown in Table 1.
Table 1
Tremor ratings for three patients with progressively worse tremor over time.
| PATIENT 1 | T1 | T2 | T3 | T4 | T5 |
|---|---|---|---|---|---|
| Date of exam | 6/23/2005 | 9/9/2014 | 4/4/2016 | 10/25/2017 | 8/1/2019 |
| Year of disease | 33 | 42 | 44 | 45 | 47 |
| Arm extension (R) | 1 | 0.5–1 | 1.5–2 | 2 | 3 |
| Wing beat (R) | – a | 1 | 1.5 | 2 | 3 |
| Finger-nose-finger (R) | 1 | 1.5 | 2 | 3 | 3–4 |
| Pouring (R) | 2 | 1.5 | 2 | 3 | 4 |
| Drinking (R) | 1.5–2 | 1 | 3 | 3 | 4 |
| Drawing spirals (R) | 1.5–2 | 1.5 | 3 | 3 | 3 |
| TTS | 17.5 | 19 | 29.5 | 30 | 34.5 |
| PATIENT 2 | T1 | T2 | T3 | T4 | T5 |
| Date of exam | 11/17/2004 | 1/16/2011 | 2/11/2015 | 9/1/2016 | 4/17/2018 |
| Year of disease | 51 | 58 | 62 | 63 | 65 |
| Finger-nose-finger (L) | 0.5 | 1–1.5 | 2 | 2 | 2 |
| Drawing spirals (L) | 1 | 2 | 2 | 2–3 | 3 |
| TTS | 16.5 | 22.5 | 25.5 | 30.5 | 30.5 |
| PATIENT 3 | T1 | T2 | T3 | ||
| Date of exam | 12/20/2003 | 11/12/2014 | 6/8/2016 | ||
| Year of disease | 46 | 57 | 59 | ||
| Arm extension (R) | 1 | 1.5–2 | 3 | ||
| Finger-nose-finger (R) | 1.5 | 2–3 | 3–4 | ||
| Pouring (R) | 2 | 3 | 4 | ||
| Drawing spirals (R) | 1.5 | 3 | 3 | ||
| TTS | 25.5 | 33 | 45 |
[i] a Video not available.
R, right. L, left. TTS, total tremor score.
Bolded scores indicate the task is shown in the video.