Tremor

INDEX

Rest Tremor amplitude is reduced in 90% of PD patients after voluntary action.  To assess resting tremor suppression by a voluntary movement (and to test for tremor re-emergence thereafter), wrist extension is often more suitable than the other postures, because this movement can be done rapidly.

Examination of patient with PD to check for lessening or disappearance of rest tremor when carrying out an action. When carrying out such a manoeuvre, typically over half of patients have abolition of rest tremor, a third have a reduction of amplitude, and about 10% have no change in tremor severity8.

 

An alternative manoeuvre to assess resting tremor suppression is shown below; to assess resting tremor suppression by a voluntary movement (and to test for tremor re-emergence thereafter), wrist extension is often more suitable than the other postures, because this movement can be done rapidly, that is, a brief ballistic movement7.

(vv)4RapidmovementandRETinPD.mp4(tt)

Video showing patient performing brief ballistic movement, with RET7.

 

Table distinguishing PD from ET

See also: main section on PD tremor PD Tremor