F.A. KHABIROV^1,2, L.A. AVERIANOVA^1,2, E.V. GRANATOV², N.N. BABICHEVA², T.I. KHAYBULLIN^1, 2

¹Kazan State Medical Academy, 11 Mushtari St., Kazan, Russian Federation, 420012

²Republican Clinical Diagnostic Center for Neurology of the Ministry of Healthcare of the Republic of Tatarstan, 13 Vatutina St., Kazan, Russian Federation, 420021

Khabirov F.A. — D. Med. Sc., Professor of the Department of Neurology and Manial Treatment, tel. (843) 278-88-29, e-mail: rkdcdz@rkbvl.ru^1,2

Averianova L.A. — neurologist, tel. (843) 278-88-29, e-mail: rkdcdz@rkbvl.ru^1,2

Granatov E.V. — PhD (Medicine), neurologist, tel +7 (843) 278-88-29, e-mail: rkdcdz@rkbvl.ru²

Babicheva N.N. — neurologist, tel. (843) 278-88-29, e-mail: rkdcdz@rkbvl.ru²

Khaybullin T.I. — PhD (Medicine), Associate Professor of the Department of Neurology and Manual Therapy, tel. (843) 278-88-29, e-mail: timuur@gmail.com^1,2

142 patients were examined: I group (n=58) — patients with multiple sclerosis (MS ) and tremor; II group (n=66) — MS without tremor; III group (n=10 ) — patients with Parkinson’s disease (PD); IV group (n=8) — patients with essential tremor (ET); V group (n=10) — healthy young volunteers. Clinico-neurophysiological examination included digital spiralography, EMG-tremorography, somatosensory evoked potentials, transcranial magnetic stimulation with tremor resetting, short- and long-latency reflexes. We revealed that tremor in MS develops during more active disease course with the dominance of brainstem and cerebella symptoms. We allocated 5 variants of tremor in MS, which differ from each other in their clinical and neurophysiological characteristics. Compared with PD and ET patients, tremor in MS patients is characterized by more variable clinical characteristics, high amplitude and impact on disability. Extrapolation of some aspects of the tremor generation in PD and ET patients helps to clarify the pathophysiology of shaking hyperkinesis in MS patients.

Key words: tremor, shaking hyperkinesis, multiple sclerosis, Parkinson’s disease, essential tremor, neurophysiology study, pathophysiology.

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