From the Guidelines
Tremors are involuntary, rhythmic muscle movements that can be classified into several distinct types, including resting tremors, action tremors, essential tremor, physiologic tremors, dystonic tremors, cerebellar tremors, and psychogenic tremors, with proper identification being crucial for determining appropriate treatment. The main types of tremors include:
- Resting tremors, which occur when muscles are relaxed and typically affect the hands, causing a characteristic "pill-rolling" motion between the thumb and fingers—this is most commonly associated with Parkinson's disease 1
- Action tremors, which occur during voluntary movement and include postural tremors (when holding a position against gravity), kinetic tremors (during movement), intention tremors (worsening as the target is approached), and task-specific tremors (during specific activities like writing)
- Essential tremor, the most common movement disorder, typically presents as a postural or kinetic tremor affecting the hands, head, or voice, and can be treated with medications like propranolol, as seen in a study published in Hypertension in 2022 1
- Physiologic tremors, which are normal, fine tremors that everyone has but become noticeable during stress, caffeine use, or certain medications
- Dystonic tremors, which are associated with abnormal postures, and can be addressed through occupational therapy, as suggested in a study published in the Journal of Neurology, Neurosurgery and Psychiatry in 2020 1
- Cerebellar tremors, which are slow, wide movements from cerebellar damage
- Psychogenic tremors, which have psychological origins Tremors can significantly impact daily activities, and their proper identification helps determine appropriate treatment, which may include medications, occupational therapy, or other interventions, depending on the specific tremor type, as discussed in various studies, including those published in the Journal of the American College of Radiology in 2020 1 and the Journal of Hepatology in 2012 1.
From the Research
Types of Tremors
- Essential tremor: a common movement disorder characterized by action tremor in bilateral upper extremities, which may also affect other locations such as the neck or vocal cords 2, 3
- Dystonic tremor: a type of tremor associated with dystonia, which may involve several different body parts and forms of tremor 2
- Parkinsonian tremor: a tremor that occurs in patients with Parkinson's disease, which can affect the upper limbs and axial muscles 4
- Rest tremor: a type of tremor that occurs when the affected body part is at rest, often seen in Parkinson's disease 2, 4
- Action tremor: a type of tremor that occurs when the affected body part is moving or performing an action, often seen in essential tremor 2, 3
- Head tremor: a type of tremor that affects the head, which can be seen in essential tremor, cervical dystonia, and Parkinson's disease 4
Classification of Tremors
- The International Parkinson Disease and Movement Disorders Society has proposed a new classification system for tremors, based on two axes: clinical features and etiology 5
- The classification system aims to reflect the underlying pathophysiology of tremors and provide a more accurate diagnosis and treatment plan 5
Rare Types of Tremors
- Monosymptomatic asymmetric rest and postural tremor: a rare condition characterized by rest and postural tremor without other major abnormalities 2
- Tremor-dominant Parkinson's disease: a subtype of Parkinson's disease characterized by prominent tremor symptoms 2, 4
- Essential tremor with tremor at rest: a rare condition characterized by essential tremor with rest tremor 2