Tremor classification

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:  Zehra Malik, M.B.B.S[2]

## Overview

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Tremor may be classified into resting or action tremor. Action tremor includes postural, kinetic (simple or intentional), isometric and task-specific tremor.

## Classification

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Tremor may be classified into two main groups: [1][2]

* Resting tremor: Occurs when the body is not moving and is at rest, the muscle is relaxed and supported against gravity. It could occur in hands, legs, or arms. Resting tremor decreases in intensity with targeted movement. Parkinson's disease and drug-induced parkinsonism exhibit resting tremors. Other causes of resting tremor are Wilson's disease, dystonia, rubral tremor (brainstem lesion), and progressive supranuclear palsy.
* Action Tremor: Could occur with any voluntary movement. It is further classified into:
* Postural Tremor: Increases with voluntary movement. Physiologic tremor, essential tremor, drug or alcohol withdrawal and metabolic changes in thyroid, kidney, liver may result in postural tremor.
* Kinetic Tremor:
* Simple kinetic: Not affected by targeted movement. Occurs with normal limb movement.
* Intentional tremor: Increases in intensity by targeted movement. Observed in cerebellar lesion caused by stroke, multiple sclerosis or tumor, spinocerebellar ataxia, vitamin E deficiency and lithium or alcohol toxicity.
* Isometric tremor: Voluntary contraction of muscle against a heavy/rigid/stationary object. For instance, making a fist, using one hand to hold a heavy object, or pushing against a wall.
* Task-induced tremor: Occurs when performing a highly skilled task, handwriting tremor, or musicians tremor.

## References

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1. ↑ Deuschl G, Bain P, Brin M (1998). "Consensus statement of the Movement Disorder Society on Tremor. Ad Hoc Scientific Committee". Mov Disord. 13 Suppl 3: 2–23. doi:10.1002/mds.870131303. PMID 9827589.CS1 maint: Multiple names: authors list (link)
2. ↑ Charles PD, Esper GJ, Davis TL, Maciunas RJ, Robertson D (1999). "Classification of tremor and update on treatment". Am Fam Physician. 59 (6): 1565–72. PMID 10193597.CS1 maint: Multiple names: authors list (link)