Tremor differential diagnosis

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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 other diseases that cause myoclonus, clonus, asterixis, and epilepsia partialis continua.

OR

[Disease name] must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Differentiating [Disease name] from other Diseases

[Disease name] must be differentiated from other diseases that cause [clinical feature 1], [clinical feature 2], and [clinical feature 3], such as [differential dx1], [differential dx2], and [differential dx3].

OR

[Disease name] must be differentiated from [differential dx1], [differential dx2], and [differential dx3].

OR

As [disease name] manifests in a variety of clinical forms, differentiation must be established in accordance with the particular subtype. [Subtype name 1] must be differentiated from other diseases that cause [clinical feature 1], such as [differential dx1] and [differential dx2]. In contrast, [subtype name 2] must be differentiated from other diseases that cause [clinical feature 2], such as [differential dx3] and [differential dx4].

Differentiating [disease name] from other diseases on the basis of [symptom 1], [symptom 2], and [symptom 3]

On the basis [symptom 1], [symptom 2], and [symptom 3], [disease name] must be differentiated from [disease 1], [disease 2], [disease 3], [disease 4], [disease 5], and [disease 6][1].

Common Cause of Tremor Type of Tremor Differentiating Feature of Tremor Main Feature of Disease
Essential tremor Action - Postural Tremor Frequency 4–12 Hz, Bilateral onset gait ataxia, vestibulocerebellar involvement, reduced by alcohol, family history, stress/fatigue can increase tremor amplitude
Parkinson’s disease Resting Tremor Unilateral onset Slow movement, stooped posture, difficulty walking, rigidity imbalance, depression, apathy
Physiologic Tremor Postural tremor High-frequency, low-amplitude
Cerebellar Tremor Intention tremor Low frequency <4 Hz Occurs in multiple sclerosis, stroke, cerebellar trauma. May feature ataxia, dysmetria, dysdiadochokinesia, and dysarthria.
Hypoglycemia Basal ganglia Quick involuntary movements (hyperkinesis)
Alcoholism Action - Postural Tremor Less movement (hypokinesis), increased muscle tone
Hyperthyroidism Action - Postural Tremor Mixed presentation

References

  1. 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.

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