Name the three types of tremors and how to elicit them
Resting tremor: Best observed when patients are distracted (i.e., counting numbers with eyes closed) and their hands are lying on the lap. Resting tremor of 4–6 Hz is typical of Parkinson’s. Amplitude and frequency of the tremor increase during stress and improve with voluntary movements. The rest tremor of the hand is often described as “pill-rolling.”
Postural tremor: Postural tremor of 6–11 Hz is best elicited by having the arms or legs maintain a particular posture against gravity (i.e., benign essential tremor of aging). There also may be titubation of head or jaw and tremulous speech.
Action tremor: Best elicited by having the patient perform common tasks, like drinking from a cup or writing. Most prominent in goal-directed movements (e.g., finger-to-nose testing) and usually associated with cerebellar lesions.
Resting tremor: Best observed when patients are distracted (i.e., counting numbers with eyes closed) and their hands are lying on the lap. Resting tremor of 4–6 Hz is typical of Parkinson’s. Amplitude and frequency of the tremor increase during stress and improve with voluntary movements. The rest tremor of the hand is often described as “pill-rolling.”
Postural tremor: Postural tremor of 6–11 Hz is best elicited by having the arms or legs maintain a particular posture against gravity (i.e., benign essential tremor of aging). There also may be titubation of head or jaw and tremulous speech.
Action tremor: Best elicited by having the patient perform common tasks, like drinking from a cup or writing. Most prominent in goal-directed movements (e.g., finger-to-nose testing) and usually associated with cerebellar lesions.