Tremor Flashcards
(13 cards)
What are the three main types of tremor based on timing?
Resting tremor (at rest), postural tremor (when holding a position), and action/intention tremor (during movement).
What is the characteristic tremor of Parkinson’s disease?
Resting “pill-rolling” tremor, typically asymmetric, improves with action, and is associated with bradykinesia and rigidity.
What are features of essential tremor?
Bilateral, symmetrical postural and action tremor, often affecting hands/head, improved with alcohol, and runs in families.
What distinguishes cerebellar tremor?
Intention tremor that worsens as the limb approaches a target, associated with ataxia, dysmetria, and nystagmus.
What are signs of a functional (psychogenic) tremor?
Abrupt onset, variability in frequency/amplitude, distractibility, and entrainment (changes when asked to mimic another movement).
What are possible causes of postural tremor?
Essential tremor, anxiety, hyperthyroidism, caffeine, beta-agonists, and drug withdrawal (e.g., alcohol).
What are common medications that can cause or worsen tremor?
Lithium, valproate, antipsychotics, SSRIs, theophylline, beta-agonists.
What blood tests are useful in tremor evaluation?
TFTs (hyperthyroidism), liver and renal function (metabolic causes), serum drug levels, and ceruloplasmin (in young patients to rule out Wilson’s disease).
What clinical features help differentiate between essential tremor and Parkinson’s disease?
Essential tremor: bilateral, no rigidity, improves with alcohol; Parkinson’s: resting tremor, asymmetrical, with bradykinesia and rigidity.
What imaging may be used in unclear cases of tremor?
DaTscan (dopamine transporter SPECT) can help differentiate Parkinsonian tremor from essential tremor.
What is the first-line treatment for essential tremor?
Propranolol or primidone; second-line includes topiramate or gabapentin.
How is tremor in Parkinson’s disease treated?
Dopaminergic therapy (levodopa, dopamine agonists), anticholinergics (for tremor-predominant disease in younger patients).
What is the treatment for disabling cerebellar tremor?
Usually supportive; treat underlying cause (e.g., MS, stroke); occupational therapy and physiotherapy are helpful.
