My hands shake--classification and treatment of tremor. Aust Fam Physician. 2009 Sep;38(9):678-83 Literature Search specification: "Essential Tremor"[Mesh] AND (("classification"[Subheading] OR "classification"[All Fields] OR "classification"[MeSH Terms]) AND ("tremor"[MeSH Terms] OR "tremor"[All Fields])) AND ("loattrfree full text"[sb] AND (Meta-Analysis[ptyp] OR Review[ptyp]) AND English[lang] AND "2008/10/27"[PDat] : "2010/10/26"[PDat])
e.g. tremor occurs when hands rest on lap
often increases with mental stress
decreases with a goal directed movement
Definition, occurring during a voluntary contraction of muscles
Classification, Kinetic, intention tremor, Isometric, Isometric tremor occurs as a result of muscle contraction against rigid stationary object, Postural, occurs when voluntarily holding a position against gravity: e.g. with arms extended in front of the body, Task specific, e.g. while writing
>6Hz = fast
<6Hz = slow
Which bodyparts are involved?
When is it present?
When does it get worse?
Think at least of Parkinson's Disease
Associated symptoms, Is there bradykinesia?, Is there rigidity?, Is gait affected?, Is there arm-swing asymmetry?
Think at least of, Alcoholism, Multiple Sclerosis, Stroke
Associated symptoms, Is there imbalance?, Is there dysarthria?, Is there ataxia?, Acute onset?, Relapsing or remitting?
Think at least of, Anxiety & panic attacks, especially in younger patients, thyrotoxicosis, Essential tremor, family history positive, improves with alcohol use
Associated symptoms, eye signs, rapid pulse, goitre, chest discomfort, palpitations, is there improvement on alcohol use?, is there a family history?