What is the cause of a left-sided hand tremor on action, also known as action tremor (intention tremor) or parkinsonian tremor?

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Differential Diagnosis for Left Sided Hand Tremor on Action

  • Single most likely diagnosis
    • Essential Tremor: This is the most common cause of action tremors, often affecting one side more than the other, and can be inherited. The tremor is typically most pronounced during voluntary movements or with posture.
  • Other Likely diagnoses
    • Parkinson's Disease: Although Parkinson's disease typically presents with a resting tremor, some patients may exhibit action tremors, especially in the early stages or as part of a broader spectrum of tremor types.
    • Dystonic Tremor: This can occur in association with dystonia, where there is an abnormal posturing of the hand, and the tremor is most noticeable during action.
    • Cerebellar Disorders: Lesions or diseases affecting the cerebellum can cause intention tremors, which are a type of action tremor that worsens as the hand approaches its target.
  • Do Not Miss (ddxs that may not be likely, but would be deadly if missed.)
    • Multiple Sclerosis: Although less common, tremors can be a presenting symptom of multiple sclerosis, especially if there are other neurological signs.
    • Stroke or Transient Ischemic Attack (TIA): A sudden onset of tremor could be indicative of a vascular event affecting the brain.
    • Wilson's Disease: An inherited disorder of copper metabolism that can cause tremors among other neurological symptoms, and is critical to diagnose early due to the availability of treatment.
  • Rare diagnoses
    • Neurodegeneration with Brain Iron Accumulation (NBIA): A group of rare, inherited disorders characterized by progressive neurological deterioration, including tremors.
    • Spinocerebellar Ataxias: A group of genetic disorders that affect the cerebellum and can cause a variety of symptoms including action tremors.
    • Whipple's Disease: A rare, systemic bacterial infection that can cause neurological symptoms including tremors, among other systemic manifestations.

Professional Medical Disclaimer

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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