Rest tremors |
Parkinson disease |
Other parkinsonian syndromes (less commonly) |
Midbrain ("rubral") tremor: rest < postural < kinetic |
Wilson disease (also acquired hepatocerebral degeneration) |
Essential tremor - only if severe: rest < < postural & action |
Postural and action ("terminal") tremors |
Physiological tremor |
Exaggerated physiological tremor (these factors can also aggravate other forms of tremor) |
Stress, fatigue, anxiety, emotion |
Endocrine: Hypoglycemia, thyrotoxicosis, pheochromocytoma, adrenocorticosteroids |
Drugs and toxins: Beta agonists, dopamine agonists, amphetamines, lithium, tricyclic antidepressants, neuroleptics, theophylline, caffeine, valproic acid, alcohol withdrawal, mercury ("Hatter's shakes"), lead, arsenic, others |
Essential tremor (familiar or sporadic) |
Primary writing tremor |
With other CNS disorders |
Parkinson disease |
Other akinetic-rigid syndromes |
Idiopathic dystonia, including focal dystonias |
With peripheral neuropathy |
Charcot-Marie-Tooth (controversial as to whether to call this the Roussy-Levy syndrome) |
Variety of other peripheral neuropathies (especially dysgammaglobulinemia) |
Cerebellar tremor |
Kinetic (intention) tremor |
Disease of cerebellar "outflow" (dentate nucleus and superior cerebellar peduncle): Multiple sclerosis, trauma, tumour, vascular, Wilson disease, acquired hepatocerebral degeneration, drugs, toxins (eg, mercury), others |
Miscellaneous rhythmical movement disorders |
Psychogenic tremor |
Orthostatic tremor |
Rhythmical movements in dystonia (dystonic tremor) |
Rhythmical myoclonus (segmental myoclonus - eg, palatal or branchial myoclonus, spinal myoclonus, limb myorhythmia) |
Oscillatory myoclonus |
Asterixis |
Clonus |
Epilepsia partialis continua |
Hereditary chin quivering |
Spasmus nutans |
Head bobbing with 3rd ventricular cysts |
Nystagmus |
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