Sandbox:ZMalik
Common Cause of Tremor | Differentiating Feature of Tremor | Main Feature of Disease |
---|---|---|
Essential tremor | Postural Tremor - Frequency 4–12 Hz, Bilateral onset | gait ataxia, vestibulo-cerebellar involvement, reduced by alcohol, family history, stress/fatigue can increase tremor amplitude, increases with voluntary movements |
Parkinson’s disease | Resting Tremor - Unilateral onset | Bradykinesia, micrographia, stooped posture, ataxia, rigidity, imbalance, depression, apathy, decreases with voluntary movements |
Physiologic Tremor | Postural tremor - High frequency 8–10 Hz, low amplitude, irregular oscillations | Tremor occurs while maintaining a posture and mostly disappears if eyes are closed or a load is placed on the muscles. Subtle innate tremor normally present in the general population. |
Enhanced Physiologic Tremor | Increased amplitude | Physiologic tremor enhanced due to fatigue, sleep deprivation, drugs, endocrine disorders, caffeine, stress. |
Cerebellar Tremor | Intention tremor - Low frequency <4 Hz | Occurs in multiple sclerosis, stroke, brainstem tumor, or cerebellar trauma. May feature ataxia, dysmetria, dysdiadochokinesia, and dysarthria. |
Drug Induced Tremor | Can enhance rest, action, postural tremors | Amiodarone, bronchodilators, lithium, metoclopramide, neuroleptics, theophylline, valproate |
Orthostatic Tremor | Essential tremor variant, high frequency 14 Hz-18 Hz | Occurs in the legs on standing and is relieved by sitting down |
Holmes tremor | Combination of rest, action, and postural tremors, Frequency 2Hz-5Hz | Mostly due to vascular lesion in mesencephalic, thalamic or both regions. |