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Tremor by Mind Map: Tremor
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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])

Tremor characteristics

Rest tremor

e.g. tremor occurs when hands rest on lap

often increases with mental stress

decreases with a goal directed movement

Action tremor

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

Both: rest + action


>6Hz = fast

<6Hz = slow








associated symptoms


Which bodyparts are involved?

When is it present?

When does it get worse?

Diagnostic approach

Rest tremor

Think at least of Parkinson's Disease

Associated symptoms, Is there bradykinesia?, Is there rigidity?, Is gait affected?, Is there arm-swing asymmetry?

intention tremor

Think at least of, Alcoholism, Multiple Sclerosis, Stroke

Associated symptoms, Is there imbalance?, Is there dysarthria?, Is there ataxia?, Acute onset?, Relapsing or remitting?

Postural tremor

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?

Treatment strategies