Tremor
Tremor Evaluation With a Neurologist
Tremor is one of the most common reasons patients see a neurologist. The key question is which type of tremor is present, because essential tremor, parkinsonian tremor, medication-induced tremor and physiologic tremor look different on examination and respond to different treatments.
How tremor patterns differ
- Essential tremor — usually with action, both hands, often the head or voice, frequently familial
- Parkinsonian tremor — usually at rest, often one-sided at onset, with slowness or stiffness
- Enhanced physiologic tremor — fine, related to caffeine, anxiety, thyroid disease or fatigue
- Medication-induced tremor — related to specific drugs
- Cerebellar tremor — worsens as the hand approaches a target
Evaluation
- Examination of tremor at rest, with posture and with action
- Handwriting and spiral testing
- Medication and caffeine review
- Thyroid and metabolic laboratory studies
- Imaging in selected cases
Treatment options
Not all tremor requires treatment. When tremor interferes with writing, eating, drinking or work, medication options exist for essential tremor and for parkinsonian tremor, and they differ substantially.
Occupational therapy strategies, weighted utensils and adaptive tools are useful. For severe, medication-resistant essential tremor, procedural options are discussed and referred when appropriate.
Lifestyle factors that influence tremor
- Caffeine and stimulant reduction
- Sleep and stress management
- Alcohol is not a treatment strategy, despite short-term suppression in essential tremor
- Strength and steadiness work with occupational or physical therapy
Frequently asked questions
- What causes tremor?
- The most common causes are essential tremor and Parkinson's disease, followed by medication effects, thyroid disease, caffeine and anxiety-related tremor. Examination characteristics separate them.
- Does tremor always progress?
- Essential tremor often progresses slowly over years, and many people never need treatment. The course depends on the type of tremor.
Care across Northwestern Illinois & Southern Wisconsin
Patients travel from McHenry County, the northwest Chicago suburbs, the Fox Valley and southern Wisconsin for this care. In-person visits take place in Crystal Lake and Woodstock, Illinois and Lake Geneva, Wisconsin. Telehealth is available to patients located anywhere in Illinois or Wisconsin when clinically appropriate.
Schedule a Neurology Appointment
Choose the scheduling line for the state where you will be located for your appointment.
In-Person Neurology Visits
Available at three office locations:
Crystal Lake, Illinois
Woodstock, Illinois
Lake Geneva, Wisconsin
Telehealth Neurology Visits
Telehealth neurology appointments are available to patients located anywhere in Illinois or Wisconsin. You do not need to live near an office, but you must be physically located in Illinois or Wisconsin at the time of the appointment.
Learn about telehealth neurology →Call to schedule
Illinois appointments: 815-337-7100. Wisconsin appointments: 262-245-0535.
Choose your visit
Our office will confirm whether an in-person or telehealth visit is appropriate and provide the details.
Insurance and referrals
Insurance participation and referral requirements vary by plan. Our office will confirm what your plan requires before your visit.
If you believe you are experiencing a medical emergency, call 911 or seek emergency medical attention.