Last reviewed: 4 Jul 2021
Last updated: 09 Mar 2018

Summary

Definition

History and exam

Key diagnostic factors

  • postural and/or kinetic tremor
  • problems with fine motor tasks

Other diagnostic factors

  • abatement of tremor after consumption of alcohol, benzodiazepines, barbiturates, or gabapentin
  • head or voice tremor
  • rest tremor

Risk factors

  • advanced age
  • FHx
  • white ancestry
  • exposure to environmental toxins

Diagnostic investigations

Investigations to consider

  • CT or MRI scan of the head
  • serum ceruloplasmin
  • 24-hour urine copper
  • TFTs
  • tremor physiology studies
  • single-photon emission computed tomography (SPECT) scan of the head

Emerging tests

  • tremor stability index

Treatment algorithm

Contributors

Authors

Sheng-Han Kuo, MD

Assistant Professor of Neurology

College of Physicians and Surgeons

Columbia University

New York

NY

Disclosures

S-HK is an author of a number of references cited in this monograph.

Ming-Kai Pan, MD, PhD

Assistant Professor of Neurology

College of Medicine

National Taiwan University

Tapei

Taiwan

Disclosures

M-KP declares that he has no competing interests.

Acknowledgements

Dr Sheng-Han Kuo and Dr Ming-Kai Pan would like to gratefully acknowledge Dr Zoltan Mari, Dr Martin Kronenbuerger, Dr Adam Burdick, and Dr Kelly D. Foote, previous contributors to this monograph. ZM has directed various educational programs, accredited (CME) by Johns Hopkins University, and has accepted honoraria for consulting. MK, AB, and KDF declare that they have no competing interests.

Peer reviewers

Roger Weis, MD

Pediatric Neurologist

Kinderneurologisches Zentrum Mainz

Mainz

Germany

Disclosures

RW declares that he has no competing interests.

Cory Toth, BSc, MD, FRCP(C)

Assistant Professor of Neurosciences

Hotchkiss Brain Institute

University of Calgary

Alberta

Canada

Disclosures

CT declares that he has no competing interests.

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