Dystonic tremor syndromes are the tremor associated with dystonia. Dystonic tremor syndromes are further classified based upon the associated the features and association of tremor with dystonia into 1] Dystonic tremor, 2] Tremor associated with dystonia and 3] Dystonia gene associated tremor. Dystonic tremor is defined as a tremor noted in the body part affected by dystonia. These tremors are usually focal, with irregular amplitudes and variable frequency (<7 Hz) and are of postural or kinetic pattern. However, tremor associated dystonia is characterised by tremor occurring in a body part not affected by dystonia but in a patient who has dystonia in other body part. Dystonia gene associated tremor is an isolated finding of tremor in a patient with a dystonic pedigree ( Deuschl G et al, 2010).
Management:
There have been various drugs used in the treatment of tremors associated with dystonia and include anticholinergics, tetrabenazine, benzodiazepines, with inconsistent results. Botulinum toxin has been noted to be effective in management of dystonic head tremors. The surgical procedures used to manage dystonia – DBS, lesionectomies have also found to be helpful in managing these tremors.