TREMOR has been defined as a series of rhythmic, involuntary and purposeless, oscillatory movements that result from the alternate contraction of opposing groups of muscles. It has been associated with many diverse disorders, some with gross neuropathological changes, as with lesions of the cerebellum or basal ganglia, and others with-out apparent anatomic alterations, as with anxiety, medication withdrawal states, and hyperthyroidism. Generalized trembling or quivering often occurs during ictal automatisms that are accompanied by affective disturbance. It is not commonly recognized, however, that tremor of more limited distribution can be a manifestation of a focal epileptic seizure. The purpose of this communication is to present the clinical, electrographic, and anatomic data of three patients in whom focal cortical discharge and episodic tremor were observed.
Report of Cases
CASE 1.—A 27-year-old right-handednn married woman was first seen at the Mayo Clinic in 1963. Her illness dated back to 1961,