Differential Diagnosis for Resting Tremor
- Single most likely diagnosis
- Parkinson's disease: This is the most common cause of resting tremor, 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 is typically an action tremor, some patients may exhibit a resting tremor, especially in more advanced cases.
- Dementia with Lewy bodies: This neurodegenerative disorder can present with resting tremor, 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 tremor, 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 a resting tremor, as well as other neurological symptoms, and is potentially treatable with chelation therapy.
- Neuroleptic-induced parkinsonism: The use of certain antipsychotic medications can cause drug-induced parkinsonism, which may present with a resting tremor.
- Rare diagnoses
- Huntington's disease: This inherited disorder can cause a resting tremor, but it is typically accompanied by other symptoms such as chorea, cognitive decline, and psychiatric disturbances.
- Spinocerebellar ataxia: Some forms of spinocerebellar ataxia can present with a resting tremor, although this is less common.
- Fragile X-associated tremor/ataxia syndrome (FXTAS): This rare genetic disorder can cause a resting tremor, as well as other neurological symptoms, in older adults with the fragile X premutation.