1. Tremor Classification and Causes

2. Definition of Tremor Rhythmic, oscillatory movement usually fixed in frequency but not in amplitude

3. Physiological Tremor Everyone has 10-12Hz tremor but it is not readily apparent Certain conditions make them more apparent Caffeine Beta agonists SSRI Fear, anxiety Withdrawal

4. Classification of Pathological Tremor Rest Tremor Tremor when movement is unnecessary and unintended Postural Tremor while keeping the body motionless against gravity Action Kinetic – tremor with voluntary movement eg. finger to nose, heel to shin Isometric – pushing against wall, table

5. 5-7Hz 3-5Hz 10-12Hz 3-4Hz

6. Mixed Positive and Negative Output Parkinson Tremor Wilson’s Disease Pars compacta – dopamine

7. Motor 10

8. Motor 11 Rubral Tremor Cerebellar “ “ Intention Tremor Pathway (MS, Trauma, CVA) Essential

9. Things to Consider Diffuse disease causing neurodegeneration and/or demyelination Peripheral (Neuropathic Tremor) - Usually Hereditary Guillain-Barre Chronic Inflammatory Demyelinating Polyneuropathy CIDP

10. Sources Kubie Neuroanatomy Review Overview of Tremor - UptoDate