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The causes of tremor are very diverse. However, even though the list of potential causes is very extensive, a few conditions are predominant. The most important will be discussed here.
Clinical Conditions Associated with Tremors
Familial and Essential Tremor
Familial and essential tremors are the most common conditions associated with action tremor. In the familial, or hereditary form, several members of the same family are affected. This is a genetically heterogeneous condition, and more than one gene might be involved.
The non-familial form is referred to as essential tremor because it is not associated with any other neurological condition. The term "benign essential tremor" has been used in reference to this tremor; however, this is misleading since the tremor can be very severe and disabling. The essential and the familial hereditary forms are similar in clinical presentation.
There is no diagnostic test that confirms the condition. The diagnosis is based on clinical findings. However some tests might be indicated to rule out other conditions.
Parkinsonian (rest) Tremor
This type of tremor is predominant in the Parkinsonian syndrome
The better known of these conditions is Parkinson's disease, a degenerative progressive disorder of the brain that predominantly affects a deep structure of the brain called the substantia nigra, located in the basal ganglia. The cause of the disease is unknown, the strongest associated risk factor being age. In some individuals, genetic factors might be important.
In Parkinson's disease the tremor is the most common initial sign. This is followed by:
In addition, the patients present with loss of facial expression and slowed speech with repetition of words. The symptoms progress slowly, and as the disease progresses the tremors are more prominent.
Other conditions with Parkinsonian Tremors
Several conditions in which Parkinsonian tremor might be an important feature include:
Last Reviewed 11/17/2017
Norberto Alvarez, MD
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