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.
Request a Neurology Appointment
Text 815-276-7050 with your first name and the word "appointment," or call 815-337-7100 to schedule. Our office will follow up to confirm your evaluation.
In-person visits and televisits (telehealth) are both available.
What happens after you text
Text 815-276-7050 with your first name and the word "appointment." Our office calls you back to schedule — you do not need to fill out a form.
When you'll hear back
Texts and calls received during office hours are typically returned the same business day. You can also call 815-337-7100 directly.
Insurance and referrals
Insurance participation and referral requirements vary by plan. Our office will confirm what your plan requires before your visit.
Please do not send urgent or emergency medical information by text. If you believe you are experiencing a medical emergency, call 911 or seek emergency medical attention. Please avoid sending sensitive medical information by ordinary SMS unless instructed otherwise.