Figure 1.

Written examples of the effect of Xyrem on ET and PWT. Written examples of the effect of Xyrem on ET and PWT appear in Figure 1. In Figure 1A, Archimedes spiral samples correspond to the video segment of patient #8 while she was filmed at fifteen minute intervals (t = 0, 15 min, 30 min, 45 min, 60 min) after receiving 1.5 gm of Xyrem. A classic ET spiral is seen at t = 0, with a characterstic axis of maximum amplitude of tremor of approximately 60 degrees. Forty five minutes later, the amplitude of the tremor is reduced, and tremor is nearly absent at sixty minutes. The frequency of the tremor is unchanged by treatment. Benefits in Archimedes spiral correlate with clinical benefits in pouring water demonstrated in patient #8’s video segment. Handwriting samlpes of a portion of the “rainbow passage” in a patient with PWT are diplayed before and one hour after treatment with 1.5 gm of Xyrem (Figure 1B). The improvement of writing tremor is only modest, but legibility is improved.