Tremor

Last updated 25.08.13

 

Index

 

Definition

-    Involuntary rhythmic & repetitive movement disorder

 

Features

-    Physiological or pathological

-    No breaks between movements

-    Described in terms of frequency & amplitude

 

DDx

-      Chorea

-      Athetosis

 

Types

-      Action tremor

-     Adrenaline tremor

-     Exagerated physiological tremor

-     Anxiety tremor: most obvious when hands outstretched

-     Thyrotoxic tremor: most obvious when hands outstretched

-     Tremor of fatigue

-     Benign essential tremor

-    One of most common tremors

-    30% pts have family Hx

-    More common in females

-    Usually starts in hands, may effect head, chin (80%) & voice

-    Worse when under observation

-    May increase during writing, drinking, eating

-    EtOH may abolish tremor

-    Intention tremor

-     Usually associated with disease of cerebellum

-     May be seen with cerebellar ataxia

-     Not seen at rest or supported

-     Only present during movement

-    Absent during first part of movement

-    As movement more precise tremor increases

-     Finger to nose test

-    Hepatic tremor: Asterixis

-    Drug induced tremor

-    Parkinsonian tremor: PD

-     Resting tremor

-     Pill rolling

-     Temporarily suppressed by movement

-    Tardive dyskinesia

 

Indications

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Indications

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References

 

Parkinsons Australia: Tremor, 1998

American Family Physician: Differentiation & Diagnosis of Tremor, Mar 15 2011