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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.

Second, I have noted an unusual pattern where after years of relative stability (often about 10 years), these patients seem to suddenly . . . [Full Text of this Article]

AUTHOR INFORMATION

David S. Russell, MD, PhD

RELATED ARTICLE

Benign Tremulous Parkinsonism
Keith A. Josephs, Joseph Y. Matsumoto, and J. Eric Ahlskog
Arch Neurol. 2006;63(3):354-357.
ABSTRACT | FULL TEXT