The clinical characteristics and related factors of tremor in patients with epilepsy.
PURPOSE
Tremor is frequently observed in patients with epilepsy (PWE), which is generally attributed to the side-effect of antiepileptic drugs (AEDs) particularly valproate (VPA) with largely unknown mechanisms. The study aimed to assess the clinical features and related factors of tremor in PWE with tremor.


METHODS
PWE with tremor and a control group of age- and sex-matched PWE without tremor were enrolled. Detailed demographic and clinical information for each individual was recorded. PWE with tremor were evaluated by The Clinical Rating Scale for Tremor (CRST) and Tremor Related Activities of Daily Living (TRADL) questionnaire.


RESULTS
132 individuals were enrolled, which including sixty-six (36 males) PWE with tremor with mean age of 33 years and epilepsy duration of 12.5 years. Tremor was postural in all, with median duration of four and one year from diagnosis and AED treatment to the onset of tremor respectively. The upper limbs were predominantly affected. VPA had been used in 62 (93.9%) PWE with tremor compared to 31 (47.0%) PWE without tremor (P < 0.001). The total CRST score was significantly associated with epilepsy duration and maximum VPA dosage (B = 0.30, p < 0.001; B = 0.32, p = 0.013). Patients with VPA dosage over 17.05 mg/kg/d might be more vulnerable to develop tremor.


CONCLUSIONS
PWE with tremor were more frequently treated with VPA, however, tremor was mild in most without any functional impairment. Epilepsy duration and maximum VPA dosage were important factors of tremor severity, suggesting mechanisms underlying tremor in PWE may be an elaborate interplay of AEDs and disease itself.
['Xiao|Yingfeng|Y|', 'Xiong|Weixi|W|', 'Lu|Lu|L|', 'Chen|Jiani|J|', 'Zhang|Yingying|Y|', 'Jiang|Xinyue|X|', 'Zhou|Dong|D|']
D000203:Activities of Daily Living D000328:Adult D000927:Anticonvulsants D016022:Case-Control Studies D064420:Drug-Related Side Effects and Adverse Reactions D004827:Epilepsy D005260:Female D006801:Humans D008297:Male D008875:Middle Aged D012720:Severity of Illness Index D011795:Surveys and Questionnaires D014202:Tremor D034941:Upper Extremity D014635:Valproic Acid D055815:Young Adult
Tremor Epilepsy Valproate CRST TRADL questionnaire