Tremor Flashcards
Essential Tremor is passed genetically via
autosomal dominant, ETOH improves tremor
what age does essential tremor start?
50-60’s can be sporadic has family history of tremor
Essential tremor involves
hands and arms (can affect head with “yes yes” or “no-no” tremor, and affect voice, chin, trunk or legs no tremor at rest. see no other neurological signs. can have varying degrees of amplitude and is evident when arm is outstretched with an increase in tremor at the very end of goal directed movement (drinking from glass, finger to nose testing)
Treatment of disabling or severe ET is
propranolol and primidone (propranolol is favored due to better side effect profile)
patient with essential tremor and asthma tx
Try atenolol because it’s selective beta 1 adrenergic blocker
beta blocker withdrawal side effects
headache, palpitations, sweating, postural hand tremors and happen within 24-36 hrs of discontinuation therapy.
intention tremor
result of cerebellar strokes. Increases in severity as hand gets closer to target
intention tremor vs essential tremor
essential tremor (genetic cause) remains constant throughout movement and increases at end of movement intention tremor (cerebellar stroke result) increases in severity as hand gets closer to target.
Postural tremor
can be result of hyperthyroidism.
Parkinson’s tremor
resting tremor that disappears with use. Also see “pill rolling” and bradykinesia tremor that occurs in legs and hands and decreases with voluntary movement
resting tremors involve
this changes with movement and can involve head and limbs
action tremors are
unchanged with movement
cerebellar stroke tremor
associated with ataxia and dysmetria tremor increases steadily as hand approaches target rather than end of goal directed movement.
hyperthyroidism tremor
more acute onset of high frequency low amplitude tremors see other manifestations of hyperthyroidism
MS tremor?
no tremor, but has spasticity in legs
chart of all tremors
