Tremor is attenuated during walking in essential tremor with resting tremor but not parkinsonian tremor

We used accelerometry and visual examination by a neurologist to measure the intensity and frequency of hand tremor under resting, postural, writing, and walking conditions among patients with essential tremor with resting tremor (n = 11) and Parkinson's disease (n = 38). The intensity of essential tremor was markedly attenuated during walking relative to resting. The intensity and frequency of parkinsonian tremors were higher while walking than while resting. We suggest that assessment of the intensity and frequency of tremor during walking is clinically useful for differentiating between essential tremor with resting tremor and parkinsonian tremor, especially in the early stages, when the two conditions are often difficult to distinguish. Parkinsonian tremors are known to be enhanced during walking. Our clinical experience, as well as that of others, suggests that the intensity of essential tremor with resting tremor is markedly attenuated during walking. (C) 2011 Elsevier Ltd. All rights reserved.