Tremor differential diagnosis: Difference between revisions

Jump to navigation Jump to search
Line 12: Line 12:
**[[Asterixis]]: On [[electromyographic]], flapping/abduction of the [[upper extremities]] is indicated as prolong absence of [[EMG]] activity.
**[[Asterixis]]: On [[electromyographic]], flapping/abduction of the [[upper extremities]] is indicated as prolong absence of [[EMG]] activity.
**[[Epilepsia partialis continua]]: Regular jerks of the arm/hand.   
**[[Epilepsia partialis continua]]: Regular jerks of the arm/hand.   
*Differentiating the cause of tremor from other [[diseases]] on the basis of the type of tremor, associated [[signs]], and [[symptoms]].<ref name="pmid19750493">{{cite journal| author=Deuschl G, Elble R| title=Essential tremor--neurodegenerative or nondegenerative disease towards a working definition of ET. | journal=Mov Disord | year= 2009 | volume= 24 | issue= 14 | pages= 2033-41 | pmid=19750493 | doi=10.1002/mds.22755 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19750493  }} </ref>.
*Differentiating the cause of tremor from other [[diseases]] on the basis of the type of tremor, associated [[signs]], and [[symptoms]].<ref name="pmid19750493">{{cite journal| author=Deuschl G, Elble R| title=Essential tremor--neurodegenerative or nondegenerative disease towards a working definition of ET. | journal=Mov Disord | year= 2009 | volume= 24 | issue= 14 | pages= 2033-41 | pmid=19750493 | doi=10.1002/mds.22755 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=19750493  }} </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><ref name="pmid21404980">{{cite journal| author=Crawford P, Zimmerman EE| title=Differentiation and diagnosis of tremor. | journal=Am Fam Physician | year= 2011 | volume= 83 | issue= 6 | pages= 697-702 | pmid=21404980 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=21404980  }} </ref>


{| class="wikitable"
{| class="wikitable"

Revision as of 04:39, 25 January 2021

Tremor Microchapters

Home

Patient Information

Overview

Historical Perspective

Classification

Pathophysiology

Causes

Differentiating Tremor from other Diseases

Epidemiology and Demographics

Risk Factors

Screening

Natural History, Complications and Prognosis

Diagnosis

Diagnostic Study of Choice

History and Symptoms

Physical Examination

Laboratory Findings

Electrocardiogram

X-ray

Echocardiography and Ultrasound

CT

MRI

Other Imaging Findings

Other Diagnostic Studies

Treatment

Medical Therapy

Surgery

Primary Prevention

Secondary Prevention

Cost-Effectiveness of Therapy

Future or Investigational Therapies

Case Studies

Case #1

Tremor differential diagnosis On the Web

Most recent articles

Most cited articles

Review articles

CME Programs

Powerpoint slides

Images

American Roentgen Ray Society Images of Tremor differential diagnosis

All Images
X-rays
Echo & Ultrasound
CT Images
MRI

Ongoing Trials at Clinical Trials.gov

US National Guidelines Clearinghouse

NICE Guidance

FDA on Tremor differential diagnosis

CDC on Tremor differential diagnosis

Tremor differential diagnosis in the news

Blogs on Tremor differential diagnosis

Directions to Hospitals Treating Tremor

Risk calculators and risk factors for Tremor differential diagnosis

Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Zehra Malik, M.B.B.S[2]

Overview

Tremor must be differentiated from diseases that cause involuntary movement: myoclonus, clonus, asterixis, and epilepsia partialis continua. The cause of tremor must also be differentiated from other conditions that cause tremor: essential tremor, physiological tremor, Parkinson's disease, cerebellar tremor, orthostatic tremor.

Differentiating Tremor from other Diseases

Common Cause of Tremor Differentiating Feature of Tremor Main Feature of Disease
Essential tremor Postural Tremor - [Frequency]] 4–12 Hz, Bilateral onset gait ataxia, vestibulocerebellar 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, low amplitude Enahanced with drug and toxins, no neurological feature
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

References

  1. Bhidayasiri R (2005). "Differential diagnosis of common tremor syndromes". Postgrad Med J. 81 (962): 756–62. doi:10.1136/pgmj.2005.032979. PMC 1743400. PMID 16344298.
  2. Deuschl G, Elble R (2009). "Essential tremor--neurodegenerative or nondegenerative disease towards a working definition of ET". Mov Disord. 24 (14): 2033–41. doi:10.1002/mds.22755. PMID 19750493.
  3. Smaga S (2003). "Tremor". Am Fam Physician. 68 (8): 1545–52. PMID 14596441.
  4. Crawford P, Zimmerman EE (2011). "Differentiation and diagnosis of tremor". Am Fam Physician. 83 (6): 697–702. PMID 21404980.

Template:WH Template:WS