neurologic disorders
Tremor
Key Points
Tremor can be classified as resting or action (which includes intention, kinetic, and postural tremors). The most common causes of tremor include physiologic tremor, essential tremor, and Parkinson disease. History and physical examination can typically identify the etiology of tremor. Consider Parkinson disease if patients have a resting tremor, consider essential or physiologic tremor if they have a postural or an action tremor, and consider cerebellar tremor if they have an intention tremor. If tremor begins abruptly or occurs in patients who are<50 and do not have a family history of benign tremor, evaluate them promptly and thoroughly with brain imaging and laboratory tests based on clinical presentation. Treat according to the cause and type of tremor: avoidance of triggers (physiologic),propranololorprimidone(essential), physical therapy (cerebellar), usuallylevodopa(parkinsonian), and possibly deep brain stimulation (disabling and drug-refractory). 