Tremor pathophysiology On the Web
American Roentgen Ray Society Images of Tremor pathophysiology
It is thought that tremor is the result of a combination of different mechanisms that could result in oscillatory/rhythmic movement. These mechanisms are mechanical oscillations, reflex oscillations, central oscillations, and cerebellar oscillation. These mechanisms differ on the basis of their origin.
- Mechanical oscillations: Occurs in limbs, could be limited to a particular joint
- Reflex oscillations: Originates from afferent muscle spindles
- Central neuronal pacemaker: Involves thalamus, basal ganglia, inferior olive.
- Cerebellar Oscillations: Disturbance in feedforward or feedback loops in cerebellum resulting in oscillations.
- It is understood that tremor is the result of oscillations produced by the above-mentioned mechanisms.
- The following are some common causes of tremor and the mechanisms from which they originate: 
|Common Causes of Tremor||Predominant Mechanism|
|Physiological tremor||Mechanical and central|
|Psychogenic tremor||Reflex (clonus)|
|Symptomatic palatal tremor||Central (inferior olive)|
|Essential tremor||Central and cerebellar (olivocerebellar circuits)|
|Parkinson's disease||Central (basal ganglia)|
|Toxic and drug‐induced tremors||Reflex|
- Essential tremor is transmitted in an autosomal dominant pattern. So far, no particular genes have been identified as the cause. In Linkage study, three susceptible loci were mapped in families with pure monogenic essential tremor: 
- Wilson's disease is transmitted in an autosomal recessive pattern. 
Conditions associated with tremor include:
- Parkinson's disease
- Drug-induced parkinsonism:Neuroleptics, metaclopromide,phenothiazines
- Wilson's disease
- Metabolic disorders: Thyrotoxicosis, pheochromocytoma, hypoglycemia
- Alcohol withdrawal
- Peripheral Neuropathy
- Orthostatic tremor
- Essential tremor
- Deuschl G, Raethjen J, Lindemann M, Krack P (2001). "The pathophysiology of tremor". Muscle Nerve. 24 (6): 716–35. doi:10.1002/mus.1063. PMID 11360255.
- Deuschl G, Krack P, Lauk M, Timmer J (1996). "Clinical neurophysiology of tremor". J Clin Neurophysiol. 13 (2): 110–21. doi:10.1097/00004691-199603000-00002. PMID 8849966.
- Elble RJ (1996). "Central mechanisms of tremor". J Clin Neurophysiol. 13 (2): 133–44. doi:10.1097/00004691-199603000-00004. PMID 8849968.
- Jiménez-Jiménez FJ, Alonso-Navarro H, García-Martín E, Lorenzo-Betancor O, Pastor P, Agúndez JA (2013). "Update on genetics of essential tremor". Acta Neurol Scand. 128 (6): 359–71. doi:10.1111/ane.12148. PMID 23682623.
- Ala A, Walker AP, Ashkan K, Dooley JS, Schilsky ML (2007). "Wilson's disease". Lancet. 369 (9559): 397–408. doi:10.1016/S0140-6736(07)60196-2. PMID 17276780.