A Review of Clinical Approach to a Patient with Tremor Disorder

Abstract

Tremor disorder is the most common movement disorder encountered in neurology and general practitioner’s clinic. The misdiagnosis of a tremor syndrome is prevalent, leading to erroneous reporting and treatment of this condition. This is our endeavor to give a simplified approach to outline Tremor disorders by reviewing the published literature on it. We searched Electronic databases MEDLINE/PubMed, Google Scholar, Cochrane library and ScopeMed with Mesh (Medical Subject Headings) terms “Tremor”, “Clinical features”, “Pathophysiology” and “treatment” from earliest possible date. Articles in any language especially those published in recent years were given preference. Tremor is classified into rest tremor and action tremor based on its presence on a different position of body parts. Action tremor is further categorized into postural, kinetic and intentional tremor. Resting tremor is classically seen in Parkinson’s disease. Essential tremor is the most common cause of postural tremor. Electromyography and accelerometer though helpful are complex tools to diagnose the tremor disorder. Tremor disorders should be approached systematically. We should proceed from the classification of tremor based on its presence in a different position of body parts. We need to corroborate clinical history, examination findings, and appropriate investigation report to reach the final etiological diagnosis of the tremor disorder.