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| {{Tremor}} | | {{Tremor}} |
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| | {{CMG}};{{AE}} {{ZMalik}} |
| | ==Overview== |
| | Common causes of tremor in primary care include enhanced [[physiologic tremor]], [[essential tremor]], and [[Parkinson’s disease]]. |
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| {{CMG}}
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| ==Overview==
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| ==Causes== | | ==Causes== |
| Tremor is generally caused by problems in parts of the brain or spinal cord that control muscles throughout the body or in particular areas, such as the hands. Neurological disorders or conditions that can produce tremor include [[multiple sclerosis]], [[stroke]], [[traumatic brain injury]] and [[neurodegenerative disease]]s that damage or destroy parts of the [[brainstem]] or the [[cerebellum]]. Other causes include the use of some drugs (such as [[amphetamine]]s, [[caffeine]], [[corticosteroid]]s, and drugs used for certain psychiatric disorders), alcohol abuse or withdrawal, [[mercury poisoning]], overactive [[thyroid]] or [[liver failure]]. Tremors can be an indication of [[hypoglycemia]], along with palpitations, sweating and anxiety. <!-- Biochemistry 3rd ed. Lippinscott illustrated reviews. Champe, Harvey, Ferrier. 2005 (for the last sentence) -->
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| Tremor can also be caused from lack of [[sleep]], [[vitamin]]s, or having too much [[stress]].
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| Deficiencies of magnesium and [[vitamin B1]] have also been known to cause tremor or shaking which resolves when the deficiency is corrected. See [[magnesium in biology]].
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| Some forms of tremor are inherited and run in families, while others have no known cause. Tremors can also be caused by some spider bites i.e. the redback spider of Australia.
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| Tremor can result from other conditions as well. [[Alcoholism]], excessive alcohol consumption, or alcohol withdrawal can kill certain nerve cells, resulting a tremor known as [[asterixis]]. Conversely, small amounts of alcohol may help to decrease familial and essential tremor, but the mechanism behind this is unknown. Tremor in [[peripheral neuropathy]] may occur when the nerves that supply the body’s muscles are traumatized by injury, disease, abnormality in the central nervous system, or as the result of systemic illnesses. Peripheral neuropathy can affect the whole body or certain areas, such as the hands, and may be progressive. Resulting sensory loss may be seen as a tremor or ataxia (inability to coordinate voluntary muscle movement) of the affected limbs and problems with gait and balance. Clinical characteristics may be similar to those seen in patients with essential tremor.
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| === Common Causes===
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| === Causes by Organ systems===
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| {|style="width:80%; height:100px" border="1"
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| |style="height:100px"; style="width:25%" border="1" bgcolor="LightSteelBlue" | '''Cardiovascular'''
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| |style="height:100px"; style="width:75%" border="1" bgcolor="Beige" |
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| |-bgcolor="LightSteelBlue"
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| | '''Chemical / poisoning'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Dermatologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Drug Side Effect'''
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| |-bgcolor="LightSteelBlue"
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| | '''Ear Nose Throat'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Endocrine'''
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| |-bgcolor="LightSteelBlue"
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| | '''Environmental'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Gastroenterologic'''
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| |-bgcolor="LightSteelBlue"
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| | '''Genetic'''
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| |-bgcolor="LightSteelBlue"
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| | '''Hematologic'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Iatrogenic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Infectious Disease'''
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| |-bgcolor="LightSteelBlue"
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| | '''Musculoskeletal / Ortho'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Neurologic'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Nutritional / Metabolic'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Obstetric/Gynecologic'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Oncologic'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Opthalmologic'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Overdose / Toxicity'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Psychiatric'''
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| |-bgcolor="LightSteelBlue"
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| | '''Pulmonary'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Renal / Electrolyte'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Rheum / Immune / Allergy'''
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| |bgcolor="Beige"|
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| |-bgcolor="LightSteelBlue"
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| | '''Sexual'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Trauma'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Urologic'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Dental'''
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| |bgcolor="Beige"| No underlying causes
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| |-bgcolor="LightSteelBlue"
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| | '''Miscellaneous'''
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| |bgcolor="Beige"|
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| |} | | ===Common Causes=== |
| === Causes by Alphabetical order=== | | Common [[causes]] include: <ref name="pmid21321834">{{cite journal| author=Puschmann A, Wszolek ZK| title=Diagnosis and treatment of common forms of tremor. | journal=Semin Neurol | year= 2011 | volume= 31 | issue= 1 | pages= 65-77 | pmid=21321834 | doi=10.1055/s-0031-1271312 | pmc=3907068 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21321834 }} </ref><ref name="pmid14596441">{{cite journal| author=Smaga S| title=Tremor. | journal=Am Fam Physician | year= 2003 | volume= 68 | issue= 8 | pages= 1545-52 | pmid=14596441 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=14596441 }} </ref> |
| | *Enhanced [[physiologic tremor]] |
| | *[[Essential tremor]] |
| | *[[Parkinson’s disease]] |
| | *Excessive [[caffeine]] |
| | *[[Psychogenic]] due to [[stress]],[[anxiety]], and [[depression]] |
| | *[[Hypoglycemia]] |
| | *[[Fatigue]] |
| | *[[Aging]] |
| | ===Less Common Causes=== |
| | Less common cause include:<ref name="EliasShah2014">{{cite journal|last1=Elias|first1=W. Jeffrey|last2=Shah|first2=Binit B.|title=Tremor|journal=JAMA|volume=311|issue=9|year=2014|pages=948|issn=0098-7484|doi=10.1001/jama.2014.1397}}</ref> |
| | *[[Wilson's disease]] |
| | *[[Multiple sclerosis]] |
| | *[[Alcohol]] [[withdrawal]] tremor |
| | *[[Hyperthyroidism]] |
| | *[[Mercury]] [[poisoning]] |
| | *[[Liver]] or [[kidney failure]] |
| | *[[Drug]] Induced Tremors |
| | *[[Orthostatic]] tremor |
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| ==References== | | ==References== |
| {{Reflist|2}} | | {{Reflist|2}} |
| [[Category:Needs content]] | | [[Category:Neurology]] |
| | [[Category:Primary care]] |
| | [[Category:Signs and symptoms]] |
| | [[Category:Medicine]] |