Scans without evidence of dopaminergic deficiency (SWEDDs)

Evidence-based neurology checklist on scans without evidence of dopaminergic deficiency (swedds): Clinical features of SWEDDS Asymmetric resting dystonic tremor Increased tone Impaired arm swing Facial hypomimia Jaw tremor Slow gait with small stride length and reduced arm swing: like in PD…

Clinical features of SWEDDS

  • Asymmetric resting dystonic tremor
  • Increased tone
  • Impaired arm swing
  • Facial hypomimia
  • Jaw tremor
  • Slow gait with small stride length and reduced arm swing: like in PD
  • Dystonic action writing tremor

Differentials of non-tremor dominant (akinetic-rigid) phenotype

Differentials of tremor dominant phenotype

SWEDDS v Parkinson’s disease (PD)

SWEDDS gait v Parkinson’s disease (PD) gait

Significance of SWEDDs

References

  1. Schwingenschuh P, Ruge D, Edwards MJ, et al. Adult onset asymmetric upper limb tremor misdiagnosed as Parkinson's disease: a clinical and electrophysiological study. Mov Disord 2010; 25:560-569.
  2. Mian OS, Schneider SA, Schwingenschuh P, Bhatia KP, Day BL. Gait in SWEDDs patients: comparison with Parkinson's disease patients and healthy controls. Mov Disord 2011; 26:1266-1273.
  3. Schirinzi T, Imbriani P, D’Elia A, Bentivoglio AR, Pisani A. Occurrence of writing tremor in patients with scans without evidence of dopaminergic deficit. Move Disord Clin Pract 2015; doi: 10.1002/mdc3.12302 (Epub ahead of issue).
  4. Bajaj N. SWEDD for the general neurologist. ACNR 2010; 10:30-31.
  5. Schwingenschuh P, Ruge D, Edwards MJ, et al. Distinguishing SWEDDs patients with asymmetric resting tremor from Parkinson's disease: a clinical and electrophysiological study. Mov Disord 2010; 25:560-569.
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