J Korean Med Assoc.  2012 Oct;55(10):987-995. 10.5124/jkma.2012.55.10.987.

Diagnosis and treatment of hand tremor

• Chung SJ

• KMID: 2192819
• DOI: http://doi.org/10.5124/jkma.2012.55.10.987

Abstract

Hand tremor is one of the most frequent movement disorders and embarrassing symptoms of a wide spectrum of diseases. Hand tremor can be classified by form in which the hand tremor occurs, the main distinction being whether the hand tremor occurs at rest or is produced by voluntary muscle contractions. Essential tremor is the most common pathologic tremor in humans. The clinical features of essential tremor are heterogeneous across patients. Parkinson's disease is a common disease in the elderly with increasing prevalence over the last decade. Rest tremor is one of the cardinal motor features of Parkinson's disease. Drug-induced hand tremor is also common and should be diagnosed accurately. Hand tremor in Wilson's disease is very important to identify because the disease can be treatable. Here, the diagnosis and treatment of hand tremor were reviewed to provide a practical guide for managing patients with hand tremor.

Keyword

Hand tremor; Essential tremor; Parkinson disease; Drug-induced tremor; Wilson's disease

MeSH Terms

Aged
Contracts
Essential Tremor
Hand
Hepatolenticular Degeneration
Humans
Movement Disorders
Muscle, Skeletal
Parkinson Disease
Prevalence
Tremor

Figure

• 

  Figure 1 The drawing of an Archimedes spirals by patients with (A) essential tremor, (B) (B) Parkinson's disease, and (C) a normal person.

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  Figure 2 The handwriting obtained from patients with (A) essential tremor and (B) Parkinson's disease (micrographia).

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  Figure 3 Brain [18F] fluorinated-N-3-fluoropropyl-2-β-carboxymethoxy-3-β-(4-iodophenyl)nortropane ([18F] FP-CIT PET) of patients with (A) essential tremor and (B) Parkinson's disease. The [18F] FP-CIT PET of a patient with essential tremor shows normal FP-CIT uptake in the bilateral striatum (A). The [18F] FP-CIT PET of a patient with Parkinson's disease shows asymmetrically decreased FP-CIT uptake in the striatum (B).

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  Figure 4 Brain computed tomography scans of patients with essential tremor who received bilateral thalamic deep brain stimulation (A) and left thalamotomy (B). The arrow indicates the nucleus ventralis intermedius of the left thalamus with a permanent radiofrequency thermolesion.

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