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Signs
 
 

Resting Tremor

 
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Overview

  • Look For

  • Tremor while at rest, that decreases with target-directed movement.
The tremor of Parkinsonism is classically pill-rolling, meaning that the thumb and forefinger and rubbed together, at a rate of 3-6hz.
  • Significance

  • Resting tremor is associated with Parkinsonism, either in the setting of Parkinson’s disease or secondary causes.
  • Causes of Parkinsonism

  • Parkinson’s disease - Parkinsonism, anosmia, REM sleep behavioural disturbance, frontal executive dysfunction, depression
  • Parkinson's plus syndromes - progressive supranuclear palsy (PSP), multiple systems atrophy (MSA), dementia with Lewy bodies (DLB), corticobasal degeneration (CBD)
  • Drugs - antipsychotics, metoclopramide, lithium
  • Normal pressure hydrocephalus
  • Hypoxic brain injury
  • Wilson’s disease
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