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Correspondence |

Benign Tremulous Parkinsonism

David S. Russell, MD, PhD
Arch Neurol. 2006;63(9):1346. doi:10.1001/archneur.63.9.1346-a.
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Drs Josephs, Matsumoto, and Ahlskog provide an excellent characterization of a Parkinson disease subtype that is often discussed anecdotally, but generally with little rigor.1 I generally agree with their analysis and find interesting their finding of a high proportion of affected relatives. Yet, I would like to add 2 notes of caution, based on my admittedly anecdotal experience with such patients.

First, I would like to emphasize that while “benign” in terms of years of slow progression and the relative lack of muscle rigidity, patients with Parkinson disease of this subtype, as the authors note, often have a markedly severe tremor, which they consider exhausting and tormenting—ie, far from “benign.” Patients in this group have often been among my most desperate patients despite their minimal rigidity and bradykinesia.

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