Cause |
Features* |
Tests |
Postural tremor (tremor when a limb is held outstretched) |
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Alcohol or a sedative (such as a benzodiazepine) when use is stopped |
Agitation and a fine tremor starting 24–72 hours after the last use of alcohol or a benzodiazepine Sometimes high blood pressure, a rapid heart rate, or fever, especially in people who are hospitalized |
A doctor's examination |
Drugs, such as
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History of drug use |
Stopping the drug to see whether the tremor goes away |
Hormonal, metabolic, and toxic abnormalities that affect the brain:
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A tremor plus one or more of the following: For hyperthyroidism: Difficulty tolerating heat, excessive sweating, an increased appetite, weight loss, bulging eyes, and frequent bowel movements |
Tests to help identify the cause, such as blood tests |
Essential tremor |
A coarse or fine, slow tremor that No other symptoms of nervous system malfunction |
A doctor's examination |
Physiologic tremor |
A fine, rapid tremor that |
A doctor's examination |
Resting tremor |
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Parkinsonism triggered by a drug, such as certain antipsychotic drugs and drugs used to relieve nausea |
A history of drug use |
Stopping the drug to see whether the tremor goes away |
A slow alternating tremor that
Often no family history of tremor and no lessening of tremor after drinking alcohol |
A doctor's examination Use of the drug levodopa to see whether improvement occurs |
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A sometimes coarse or jerky tremor that is often inconspicuous In older people who have difficulty looking down and eventually looking up, muscle stiffness, difficulty moving, early falls, and dementia |
A doctor's examination |
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Intention tremor |
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A slow tremor that In some people, a family history of the disorder (as for Friedreich ataxia or spinocerebellar ataxias) |
MRI of the brain |
Drugs, such as |
A history of drug use |
Stopping the drug to see whether the tremor goes away |
Complex tremors |
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Disorders that affect many of the nerves outside the brain and spinal cord (polyneuropathies): |
A tremor that |
Electromyography (stimulating muscles and recording their electrical activity) Other tests to identify the cause |
Psychogenic tremor (due to psychologic factors) |
A tremor that |
A doctor's examination |
* Features include symptoms and results of the doctor's examination. Features mentioned are typical but not always present. |
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MRI = magnetic resonance imaging; SSRIs = selective serotonin reuptake inhibitors (a type of antidepressant). |