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 Table of Contents  
IMAGES IN MEDICINE
Year : 2018  |  Volume : 31  |  Issue : 5  |  Page : 308

Tongue tremor: An unusual presentation of Parkinson disease


1 Department of Medicine, Dr S.N. Medical College, Jodhpur, Rajasthan, India
2 Department of Medicine, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India
3 Department of Medicine, S.M.S. Medical College, Jaipur, Rajasthan, India

Date of Web Publication24-Jun-2019

Correspondence Address:
Deepak Kumar
Department of Medicine, Dr S.N. Medical College, Jodhpur, Rajasthan
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0970-258X.261182


How to cite this article:
Kumar D, Bohra GK, Agarwal M. Tongue tremor: An unusual presentation of Parkinson disease. Natl Med J India 2018;31:308

How to cite this URL:
Kumar D, Bohra GK, Agarwal M. Tongue tremor: An unusual presentation of Parkinson disease. Natl Med J India [serial online] 2018 [cited 2019 Nov 18];31:308. Available from: http://www.nmji.in/text.asp?2018/31/5/308/261182



A 56-year-old woman presented with complaints of decreased sleep, low mood but no history of tremor. A complete history and clinical examination were done, which revealed bradykinesia, mask-like face and significant tongue tremor (video available at www.nmji.in) in the resting state. Her relevant investigations and magnetic resonance imaging of the brain were normal. We started levodopa plus carbidopa for her problems and there was improvement in her sleep, mood, tongue tremors and bradykinesia.
Figure 1: Tongue tremor in Parkinson disease (video available at www.nmji.in)

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Parkinson disease typically presents as unilateral tremor in the upper extremities, rigidity and bradykinesia. Of these, resting tremors are most characteristic of Parkinson disease.[1] The re-emergent characteristic of the Parkinson disease tremor is a key feature which helps to differentiate it from essential tremor.[2]

Tongue tremor may be an early sign of Parkinson disease. This observation illustrates that Parkinson disease rest tremor can affect various body parts, going from the classical asymmetrical hand or foot tremors to a much less common presentation such as head tremors.[3]

Conflicts of interest. None declared



 
  References Top

1.
Sethi KD. Clinical aspects of Parkinson disease. Curr Opin Neurol 2002;15:457-60.  Back to cited text no. 1
    
2.
Jankovic J, Schwartz KS, Ondo W. Re-emergent tremor of Parkinson’s disease. J Neurol Neurosurg Psychiatry 1999;67:646-50.  Back to cited text no. 2
    
3.
Jaulent P, Laurencin C, Robert H, Thobois S. Parkinson’s disease revealed by a resting tongue tremor. Mov Disord Clin Pract 2015;2: 432-3.  Back to cited text no. 3
    


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