What is the differential diagnosis of resting tremors (Parkinsonian tremors)?

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Differential Diagnosis for Resting Tremors

  • Single most likely diagnosis
    • Parkinson's disease: This is the most common cause of resting tremors, characterized by a pill-rolling tremor that is most prominent at rest and decreases with voluntary movement.
  • Other Likely diagnoses
    • Essential tremor: Although essential tremor typically presents as an action tremor, some patients may exhibit resting tremors, especially in more advanced cases.
    • Dementia with Lewy bodies: This neurodegenerative disorder can present with resting tremors, cognitive decline, and visual hallucinations.
    • Parkinson-plus syndromes (e.g., multiple system atrophy, progressive supranuclear palsy): These conditions often present with parkinsonian features, including resting tremors, but may have additional symptoms such as autonomic dysfunction or vertical gaze palsy.
  • Do Not Miss diagnoses
    • Wilson's disease: This rare genetic disorder can cause resting tremors, as well as other neurological symptoms, and is potentially treatable with chelation therapy.
    • Neurosyphilis: This condition can cause a variety of neurological symptoms, including resting tremors, and is important to diagnose due to its treatability with antibiotics.
  • Rare diagnoses
    • Huntington's disease: This autosomal dominant disorder can cause chorea, but some patients may exhibit resting tremors, especially in the early stages.
    • Spinocerebellar ataxia: Some subtypes of this disorder can cause resting tremors, in addition to ataxia and other neurological symptoms.
    • Fragile X-associated tremor/ataxia syndrome (FXTAS): This condition is caused by a premutation in the FMR1 gene and can cause resting tremors, ataxia, and other neurological symptoms in older adults.

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This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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