Objective: Eyebrow tremor is uncommon and only few cases have been described in the medical literature; to our knowledge only in one patient it was related to Parkinson´s disease (PD). We present a patient whose initial PD clinical manifestation was an isolated eyebrow tremor.

Background: Isolated eyebrow tremor is uncommon and only few cases have been described in the medical literature related to essential tremor. To our knowledge this tremor was not reported related to PD.

Methods: A 76 year-old male presented with a continuous and rhythmic, lifting movement of both eyebrows that resulted socially disturbing (VIDEO). It did not improve with alcohol intake. No family history of tremor. No prior drugs intake. The initial examination was normal except for the presence of this movement. Cranial MRI and blood test were normal. Frontal muscle EMG disclosed a rhythmic tremor of 5-6 Hz at rest and while talking. At interstimulus intervalis of 100 an increased R2 recovery of the blink reflex was observed.

Results: Two years later the patient developed a jaw tremor and a hypokinetic-rigid syndrome. A DAT-scan showed a bilateral reduction in both striatums. He was diagnosed of PD. Treatment with Levodopa did not improve patient tremor, and the patient refused treatment with Botulinum Toxin.

Conclusions: Isolated eyebrow tremor can be the initial manifestation of PD. The knowledge of its existence, and its detection and recognition, can help the early diagnosis of the disease. This form of tremor should be recognized because probably may be more common than is identified.

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MDS Abstracts - https://www.mdsabstracts.org/abstract/isolated-eyebrow-tremor-as-an-initial-presentation-form-of-parkinsons-disease/