UPPER AIRWAY DYSFUNCTION IN PATIENTS WITH ESSENTIAL TREMOR

Objectives: To investigate pulmonary function abnormalities in essenti al tremor. Methods: We obtained maximal inspiratory and expiratory flo w-volume curves in 41 unselected patients with essential tremor (14 ma les, 27 females, age 61.7 +/- 2.14 years). Severity of essential tremo r was evaluated using the Fahn, Tolosa and Marin clinical scale. Resul ts: Sixteen patients (39.0%) had now oscillations on the flow-volume c urves (8 only during inspiration, 7 during inspiration and expiration, and 1 with flow oscillations during inspiration and obstructive patte rn). The duration and severity of the essential tremor did not influen ce the pattern of the curve, but abnormal curves were more frequent in patients with voice tremor. Although there were a number of significa nt correlations between essential tremor scales and spirografic parame ters, they were of very low range. Four patients (9.8%) fulfilled crit eria for physiological upper airway obstruction: 2 had smooth flow-vol ume loop contour and 2 had flow oscillations in inspiration and expira tion. Conclusion: Abnormalities in flow-volume loop contour are a usua l finding in essential tremor. This probably reflects involvement of t he upper airway musculature, that in some patients can produce clinica l upper airway obstruction.