Tremers

Question 1

Types of tremors

Answer 1

1-Resting- decrease with target directed movement, limb supported against gravity
muscle are not activated
Eg-Parkinson’s, Parkinsonism-neuroleptic, metoclopramide.

2-Action

Question 2

Types of Action tremors

Answer 2

Postural- physiologic, essential, drug alcohol withdrawal, metabolic
Kinetic
- simple kinetic-no change with target directed movement
- intention- increase with target directed movement cerebellar lesion, MS, drug ( lithium, alcohol)
Isometric
Task specific ( handwriting, musician)

Question 3

Resting tremors
On medication
/. \ yes
No
Other signs of parkinson. Parkinsonism drug
Rigidity
Bradykinesia
Post. Instability
Yes /. \ no
Possible early parkinson
Trial of. Monitor
dopmimenergic
drugs

Answer 3

Postural
Pt on medication
/. Yes \ no
Drug reaction. H/o alcohol abuse
/yes. No\
Possible withdrawl. S/s of systemic illness
Yes/. \no
Enhanced physiologic tremors. Essential T.
/
Trial of b. Blocker or primidone