Summary
The differential diagnosis of tremor is based on the clinical distinction of rest, postural and intention tremor and the presence of additional clinical signs and data from the medical history. The most common pathological tremors are essential tremor and the tremors of Parkinson’s disease. Among the patients with essential tremor those with intention tremor are often misdiagnosed as cerebellar tremors. Patients with monosymptomatic resting tremors represent a special subgroup of Parkinson’s disease. Primary orthostatic tremor and dystonic tremor are rare clinical syndromes which have recently been well defined. Holmes’ tremors are defined by their low frequency and the occurence of resting and intention tremor. Palatal tremor can be separated into two subgroups. Psychogenic tremor can be diagnosed on the basis of clinical criteria. The gold standard of tremor differential diagnosis is still based on clinical criteria.
This contribution is based on two recently published overviews (Deuschl et aI., 1998; Krack et al., 1998).
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Bain PG, Findley LJ, Thompson PD, Gresty MA, Rothwell JC, Harding AE, Marsden CD (1994) A study of hereditary essential tremor. Brain 117: 805–824
Bain PG, Britton TC, Jenkins IH, Thompson PD, Rothwell JC, Thomas PK, Brooks DJ, Marsden CD (1996) Tremor associated with benign IgM paraproteinaemic neuropathy. Brain 119: 789–799
Brooks DJ (1993) PET studies on the early and differential diagnosis of Parkinson’s disease. Neurology 43
Dalakas MC, Teravainen H, Engel WK (1984) Tremor as a feature of chronic relapsing and dysgammaglobulinemic polyneuropathies. Incidence and management. Arch Neurol 41: 711–714
Deuschl G, Mischke G, Schenck E, Schulte-Mönting J, Lucking CH (1990) Symptomatic and essential rhythmic palatal myoclonus. Brain 113: 1645–1672
Deuschl G, Toro C, Valls SJ, Zeffiro T, Zee DS, Hallett M (1994) Symptomatic and essential palatal tremor. 1. Clinical, physiological and MRI analysis. Brain 117: 775–788
Deuschl G, Krack P, Lauk M, Timmer J (1996) Clinical electrophysiology of tremor. J Clin Neurophysiol 13: 110–122
Deuschl G, Bain P, Brin M (1998) Tremor: Consensus-statement of the Movement Disorder Society. Mov Disord 13 (Suppl) 3: 2–23
Findley LJ, Koller WC (1995) Handbook of tremor disorders. Marcel Dekker, New York
Holmes G (1904) On certain tremors in organic cerebral lesions. Brain 27: 327–375
Ikeda A, Kakigi R, Funai N, Neshige R, Kuroda Y, Shibasaki H (1990) Cortical tremor: a variant of cortical reflex myoclonus. Neurology 40: 1561–1565
Jankovic J, Van der Linden C (1988) Dystonia and tremor induced by peripheral trauma: predisposing factors. J Neurol Neurosurg Psychiatry 51: 1512–1519
Koller WC, Busenbark K, Miner K (1994) The relationship of essential tremor to other movement disorders: report on 678 patients. Essential Tremor Study Group. Ann Neurol 35: 717–723
Krack P, Deuschl G (1998) Tremor. In: Hopf H, Diener GD H C, Reichmann H (eds) Handbuch der Neurologie. Thieme, Stuttgart
Miwa H, Hatori K, Kondo T, Imai H, Mizuno Y (1996) Thalamic tremor: case reports and implications of the tremor-generating mechanism. Neurology 46: 75–79
Rivest J, Marsden CD (1990) Trunk and head tremor as isolated manifestations of dystonia. Mov Disord 5: 60–65
Rosenbaum F, Jankovic J (1988) Focal task-specific tremor and dystonia: categorization of occupational movement disorders. Neurology 38: 522–527
Shibasaki H (1995) Myoclonus. Curr Opin Neurol 8: 331–334
Silfverskiöld BP (1986) Rhythmic myoclonias including spinal myoclonus. In: Fahn S, Marsden CD, Van Woert M (eds) Advances in neurology. Raven Press, New York, pp 275–285
Spieker S, Jentgens C, Boose A, Dichgans J (1995) Reliability, specificity and sensitivity of long-term tremor recordings. Electroencephalogr Clin Neurophysiol 97: 326–331
Thomas JE, Reagan TJ, Klass DW (1977) Epilepsia partialis continua. Arch Neurol 34: 266–275
Young RR, Shahani BT (1986) Asterixis: one type of negative myoclonus. In: Fahn S, Marsden CD, Van Woert M (eds), Myoclonus. Raven Press, New York, pp 137–156
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1999 Springer-Verlag Wien
About this paper
Cite this paper
Deuschl, G. (1999). Differential diagnosis of tremor. In: Przuntek, H., Müller, T. (eds) Diagnosis and Treatment of Parkinson’s Disease — State of the Art. Journal of Neural Transmission. Supplementa, vol 56. Springer, Vienna. https://doi.org/10.1007/978-3-7091-6360-3_14
Download citation
DOI: https://doi.org/10.1007/978-3-7091-6360-3_14
Publisher Name: Springer, Vienna
Print ISBN: 978-3-211-83275-2
Online ISBN: 978-3-7091-6360-3
eBook Packages: Springer Book Archive