Tremor

Question 1

What are the differentials for tremor?

Answer 1

Parkinson's Disease 
Benign essential tremor 
MS
Huntington's chorea
Hyperthyroidism
Fever 
Medications e.g. antipsychotics

Question 2

What is/are the causes of resting tremor?

Answer 2

Parkinson’s disease

Parkinsonism

Question 3

What are the causes of action/postural tremor?

Answer 3

BEATS
Benign essential tremor
Endocrine e.g. hyperthyroidism, low glucose, phaeo
Alcohol withdrawal (or caffeine/ opioids)
Toxins - beta agonists, theophylline, valproate, PHE
Sympathetic: phsyiological tremor may be enhanced e.g. anxiety

Question 4

What are the features of a resting tremor

Answer 4

4-6Hz, pill rolling
Abolished on voluntary movement
Increased with distraction

Question 5

What are the features of action/ postural tremor?

Answer 5

6-12Hz
Absent at rest
Worst with outstretched hands or movement
Equally bad at all stages of movement

Question 6

What are the causes of intention tremor?

Answer 6

Cerebellar damage

Question 7

What are the features of intention tremor

Answer 7

> 6Hz, irregular, large amplitude
Worse at end of movement
e.g. past pointing

Question 8

Features & causes of dystonic tremor?

Answer 8

Features are variable

Causes: Mostly idiopathic as for dystonia