Differential Diagnosis for Tremors
Single Most Likely Diagnosis
- Essential Tremor: This is the most common cause of tremors, characterized by a bilateral, symmetric tremor that typically affects the hands, but can also involve the head, voice, or other body parts. It is often familial and can be exacerbated by stress, fatigue, or certain medications.
Other Likely Diagnoses
- Parkinson's Disease: A neurodegenerative disorder that can cause a resting tremor, often accompanied by bradykinesia, rigidity, and postural instability.
- Enhanced Physiological Tremor: An exacerbation of the normal physiological tremor that everyone experiences, often caused by stress, anxiety, fatigue, or certain medications such as beta-agonists or caffeine.
- Cerebellar Tremor: A tremor that occurs with cerebellar lesions or diseases, such as stroke, tumor, or multiple sclerosis, often characterized by an intention tremor (worsening as the hand approaches a target).
Do Not Miss Diagnoses
- Wilson's Disease: A rare genetic disorder that can cause a tremor, along with liver disease, psychiatric symptoms, and Kayser-Fleischer rings (copper deposits in the cornea). If missed, it can lead to severe liver damage and neurological deterioration.
- Thyroid Storm: A life-threatening condition caused by excessive thyroid hormone production, which can cause a tremor, along with other symptoms such as tachycardia, fever, and agitation.
- Pheochromocytoma: A rare tumor of the adrenal gland that can cause episodic hypertension, tachycardia, and tremors, often accompanied by headaches, sweating, and palpitations.
Rare Diagnoses
- Huntington's Disease: A rare genetic disorder that can cause a choreiform tremor (involuntary, dance-like movements), along with cognitive decline, psychiatric symptoms, and motor dysfunction.
- Spinocerebellar Ataxia: A group of rare genetic disorders that can cause a cerebellar tremor, along with ataxia, dysarthria, and other neurological symptoms.
- Whipple's Disease: A rare infectious disease caused by Tropheryma whipplei, which can cause a tremor, along with weight loss, diarrhea, and arthralgias.