• Rodger J. ElbleEmail author


Tremor is a common neurological sign, but it has little diagnostic value unless it is properly characterized with a thorough history and physical exam. Broadly speaking, tremor may be the only physical abnormality (isolated tremor), or it may be combined with other neurologic or systemic signs (combined tremor). Essential tremor is the most common example of an isolated tremor syndrome, and rest tremor with parkinsonism is the most common combined tremor syndrome. However, there are many other isolated and combined tremor syndromes that occur in the elderly. These tremor disorders include dystonic tremor, action tremor with ataxia, focal and task-specific tremors, isolated bi-brachial tremor, and orthostatic tremor. Four tremor syndromes may occur acutely or subacutely: (1) whole body tremulousness with myoclonus, (2) isolated bi-brachial action tremor, (3) rest tremor with parkinsonism, and (4) focal or unilateral tremor with associated focal signs. The differential diagnosis and treatment of these tremor syndromes are summarized in this chapter.


Tremor Dystonia Ataxia Myoclonus Parkinson disease Essential tremor Tremor definition and classification 



This work was supported by the Spastic Paralysis Research Foundation of Kiwanis International, Illinois-Eastern Iowa District.

Disclosures Rodger Elble receives research grant support from the Spastic Paralysis Research Foundation of Kiwanis International, Illinois-Eastern Iowa District, and he received consulting fees from Sage Therapeutics. He was also paid by InSightec to rate videotaped exams of patients undergoing thalamotomy with high-intensity focused ultrasound.


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Copyright information

© Springer International Publishing AG 2017

Authors and Affiliations

  1. 1.Department of NeurologySouthern Illinois University School of MedicineSpringfieldUSA

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