Terminology for Tremor During Voluntary Movement
Yes, a tremor that appears when trying to pick things up or during fine motor skills is called an intention tremor (also known as kinetic or action tremor), not "intentional" tremor. This type of tremor worsens during goal-directed movements and is characteristically associated with cerebellar pathology 1, 2.
Key Distinguishing Features
Intention tremor has specific characteristics that differentiate it from other tremor types:
- Worsens with goal-directed movement: The tremor becomes more pronounced as the limb approaches its target during voluntary movements like reaching for objects or performing fine motor tasks 1, 2
- Coarse and irregular pattern: Unlike the fine, regular oscillations of essential tremor, intention tremor is typically coarse and irregular 1
- "Wing-beating" appearance: During finger-to-nose testing, the tremor often displays a characteristic wing-beating pattern 1, 2
- Associated cerebellar signs: Intention tremor is frequently accompanied by dysarthria (speech difficulties) and ataxic gait (unsteady walking), indicating cerebellar dysfunction 1, 2
Clinical Context and Differential Diagnosis
The activation pattern is critical for accurate diagnosis:
- Action tremors (including intention tremor) occur during voluntary muscle contraction and can be subdivided into postural, kinetic, and intention tremors 3, 4
- Intention tremor specifically indicates cerebellar pathology or disruption of cerebellar connections 1, 2
- This differs from essential tremor, which primarily manifests as bilateral action tremor during activities like drinking or writing but does not necessarily worsen as the target is approached 1, 5
- It also differs from resting tremor (as in Parkinson's disease), which occurs when the body part is relaxed and supported against gravity 3, 6
Important Clinical Pitfall
Do not confuse "intention tremor" with "intentional tremor" - the correct medical terminology is "intention tremor," referring to tremor that worsens with the intention to reach a target, not a tremor that is somehow deliberate or voluntary 1, 2, 3.
Treatment Considerations
Intention tremor is more challenging to treat than essential tremor:
- Pharmacological options are limited compared to essential tremor, though some medications may provide benefit 1
- Physical and occupational therapy with adaptive devices can help improve function 1
- For functional tremor (a distinct entity), specific rehabilitation strategies include superimposing alternative rhythms and using gross rather than fine movements 7