Differential Diagnosis for Resting Tremor
- Single most likely diagnosis
- Essential Tremor: This is the most common movement disorder and can present with a resting tremor, although it's more commonly associated with action tremors. The justification for considering essential tremor as the single most likely diagnosis lies in its high prevalence and the broad range of tremor types it can manifest, including resting tremors in some cases.
- Other Likely diagnoses
- Parkinson's Disease: A classic cause of resting tremor, often presenting unilaterally and associated with other parkinsonian features such as bradykinesia, rigidity, and postural instability. The likelihood of Parkinson's disease is high due to its well-documented association with resting tremors.
- Dystonic Tremor: Can manifest as a resting tremor, especially when dystonia affects the limb involved. The tremor in dystonia can be quite variable and may resemble a resting tremor, making it a plausible diagnosis.
- Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
- Wilson's Disease: A rare genetic disorder that leads to copper accumulation in the body, causing neurological symptoms including tremors, which can be resting or action. Missing this diagnosis can be fatal due to the potential for liver failure and severe neurological deterioration if left untreated.
- Neurodegeneration with Brain Iron Accumulation (NBIA): A group of rare genetic disorders characterized by progressive neurological deterioration and iron accumulation in the brain, which can present with a variety of movement disorders including resting tremor. The severity and potential for rapid progression make this a critical diagnosis not to miss.
- Rare diagnoses
- Fragile X-associated Tremor/Ataxia Syndrome (FXTAS): A condition affecting older males with the fragile X premutation, characterized by tremor, ataxia, and other neurological features. It's rare but should be considered in the appropriate clinical context.
- Spinocerebellar Ataxias (SCAs): A group of autosomal dominant disorders that primarily affect the cerebellum, leading to ataxia and sometimes tremors, which can include resting tremors. The rarity and genetic basis of these conditions make them less likely but important to recognize for genetic counseling and management.