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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