Valproate-induced rest tremor and parkinsonism

  • José Fidel Baizabal-CarvalloEmail author
  • Marlene Alonso-Juarez
Original article


Tremor and parkinsonism are recognized side effects of valproate; however, the relationship between rest tremor and other signs of parkinsonism has not been addressed in patients taking valproate. We studied a cohort of 125 consecutive patients treated with valproate due to epilepsy or migraine, evaluated with the Fahn–Tolosa–Marin Tremor Rating Scale (FTM-TRS). A total of 14 (11.2%) patients had rest tremor (bilateral n = 10, unilateral n = 4). Patients with rest tremor had significant higher scores in the FTM-TRS (P < 0.001), but only one was diagnosed with parkinsonism. Patients may have valproate-induced parkinsonism or exacerbated motor features of Parkinson’s disease by valproate. The frequency of parkinsonism was 1.6% in this cohort and of 3% in the pooled data of 717 patients from previous reports. Rest tremor is observed in 11.2% of patients treated with valproate and is related to the burden of valproate-induced tremor, rather than the presence of parkinsonism.


Tremor Drug-induced tremor Valproate Anticonvulsants Parkinsonism 


Author contributions

JFB: 1A, 1B, 1C, 3A, 3B. MA: 1B, 1C, 3A. [(1) Research project: A. conception, B. organization, C. execution. (2) Statistical analysis: A. design, B. execution, C. review and critique. (3) Manuscript: A. writing of the first draft, B. review and critique.]



Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

The authors confirm that the approval of the institutional review board was obtained for this work. We confirm that we have read the journal’s position on issues involved in ethical publication and affirm that this work is consistent with those guidelines.

Supplementary material

13760_2019_1239_MOESM1_ESM.docx (17 kb)
Supplementary material 1 (DOCX 17 kb)


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Copyright information

© Belgian Neurological Society 2019

Authors and Affiliations

  1. 1.University of GuanajuatoGuanajuatoMexico
  2. 2.National Polytechnic InstituteMéxicoMexico

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