Diagnosing common types of tremor in two shakes

Abstract

Tremor is defined as an involuntary, oscillatory, rhythmic movement of a body part produced by the alternating contractions of antagonistic pairs or muscles. It is the most common movement abnormality encountered and investigated in both primary care and neurology practice. Tremor is not a diagnosis in itself; rather it is symptomatic of an underlying disorder that should be identified and when possible treated. The diagnostic process ought to include a detailed medical history, a careful assessment of the characteristics of the tremor and a search for other neurological or physical signs. This process may present challenges, particularly in describing tremor phenomenology and linking it to the likely diagnosis. This article outlines briefly the main points to explore when evaluating a patient’s tremor history, the key characteristics of tremor that should be examined for and the correct nomenclature for their description, followed by an overview of the common types of tremor encountered in clinical settings and pointers to their diagnosis.