Tremors

“Good Bye Pipe” these were the first words uttered by an 85 year old gentleman after a successful tremor surgery, enabling him to drink with his hands instead of straw…

Overview

Tremor is defined as a rhythmic involuntary movement of a body part, due to regular rhythmic muscle contractions. It is often categorized in three positions which are:

Static tremor occurs when a relaxed limb is fully supported at rest. This type of tremor is typically seen in patients of Parkinson’s disease

Postural tremor appears when a body part is maintained in a fixed position. It and may also persist during movement. This tremor is seen in patients of essential tremors/post stroke tremors etc.

Intention or action tremor occurs specifically during active voluntary movement of a body part. If the amplitude of such an action tremor increases as goal-directed movement approaches the target. This is seen in patients of spin cerebellar ataxia, multiple sclerosis, etc.

Psychogenic tremors are generally rare and typically are of sudden onset with a variable but rarely remitting clinical course and typically affect the trunk or limb with standing and/or using the limb respectively.

The frequency, amplitude and severity of the tremor may vary from patient to patient.

REST TREMORSACTION TREMORS
POSTURALKINETICMISCELLANEOUS
Pariksonian
ET variants
Midbrain lesions
Myorhythmia
Physiologic
Enhanced
Physiologic
(Stress, drugs, endocorine)
ET
Orthostatic
PD (reemergent)
Dystonia
Cerebellar
Neuropathic
Cerebellar
Lession as in MS
Stroke, Wilson
Disease
Midbrain
Task Specific
Idiopathic
Psychogenic
Other
Involuntary
Movements like
Myoclonus
Fasciculations
Asterixis, Clonus