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Essential Tremor Differential Diagnoses

  • Author: Deborah A Burke, MD; Chief Editor: Selim R Benbadis, MD  more...
 
Updated: Jul 08, 2016
 
 

Diagnostic Considerations

Conditions to consider in the differential diagnosis of essential tremor include the following:

  • Cerebellar tremor
  • Dystonia and dystonic tremors
  • Enhanced physiologic tremor
  • Isolated chin tremor
  • Isolated voice tremor
  • Movement disorders
  • Orthostatic tremor
  • Palatal tremor
  • Rubral tremor
  • Writer's tremor and other task-specific tremors
  • Psychogenic tremor

Drug-induced tremors can result from the following:

  • Antidepressants, especially tricyclics
  • Beta agonists
  • Depakote
  • Dopamine
  • Lithium
  • Metoclopramide
  • Neuroleptics
  • Theophylline
  • Thyroid hormones
  • Withdrawal of drugs

Metabolism-related tremors can result from the following disorders:

  • B-12 deficiency
  • Hyperthyroidism
  • Hyperparathyroidism
  • Hypocalcemia
  • Hyponatremia
  • Kidney disease
  • Liver disease

Toxin-related tremors can result from the following :

  • Alcohol
  • Arsenic
  • Caffeine
  • Dichlorodiphenyltrichloroethane (DDT)
  • Lead
  • Nicotine
  • Toluene
  • Withdrawal of alcohol, cocaine

Differential Diagnoses

 
 
Contributor Information and Disclosures
Author

Deborah A Burke, MD Clinician, Sub-Investigator, Movement Disorder/Parkinson's Disease Center, University of South Florida College of Medicine; Investigator, Physician, Roskamp Institute Memory Clinic

Deborah A Burke, MD is a member of the following medical societies: American Academy of Neurology, International Parkinson and Movement Disorder Society

Disclosure: Nothing to disclose.

Coauthor(s)

Robert A Hauser, MD, MBA Professor of Neurology, Molecular Pharmacology and Physiology, Director, USF Parkinson's Disease and Movement Disorders Center, National Parkinson Foundation Center of Excellence, Byrd Institute, Clinical Chair, Signature Interdisciplinary Program in Neuroscience, University of South Florida College of Medicine

Robert A Hauser, MD, MBA is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Society of Neuroimaging, International Parkinson and Movement Disorder Society

Disclosure: Received consulting fee from Cerecor for consulting; Received consulting fee from L&M Healthcare for consulting; Received consulting fee from Cleveland Clinic for consulting; Received consulting fee from Heptares for consulting; Received consulting fee from Gerrson Lehrman Group for consulting; Received consulting fee from Indus for consulting; Received consulting fee from University of Houston for consulting; Received consulting fee from AbbVie for consulting; Received consulting fee from Adama.

Theresa A McClain, RN, MSN, ARNP-BC Advanced Registered Nurse Practitioner and Investigator, Parkinson’s Disease and Movement Disorders Center, University of South Florida College of Medicine

Theresa A McClain, RN, MSN, ARNP-BC is a member of the following medical societies: Sigma Theta Tau International

Disclosure: Received consulting fee from Teva for consulting; Received consulting fee from Schering Plough for consulting; Received consulting fee from Biotie for consulting; Received consulting fee from Novartis for consulting.

Chief Editor

Selim R Benbadis, MD Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, Tampa General Hospital, University of South Florida College of Medicine

Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Medical Association, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society

Disclosure: Serve(d) as a director, officer, partner, employee, advisor, consultant or trustee for: Cyberonics; Eisai; Lundbeck; Sunovion; UCB; Upsher-Smith<br/>Serve(d) as a speaker or a member of a speakers bureau for: Cyberonics; Eisai; Glaxo Smith Kline; Lundbeck; Sunovion; UCB<br/>Received research grant from: Cyberonics; Lundbeck; Sepracor; Sunovion; UCB; Upsher-Smith.

Acknowledgements

Nestor Galvez-Jimenez, MD, MSc, MHA Chairman, Department of Neurology, Program Director, Movement Disorders, Department of Neurology, Division of Medicine, Cleveland Clinic Florida

Nestor Galvez-Jimenez, MD, MSc, MHA is a member of the following medical societies: American Academy of Neurology, American College of Physicians, and Movement Disorders Society

Disclosure: Nothing to disclose.

Daniel H Jacobs MD, FAAN, Associate Professor of Neurology, University of Florida College of Medicine; Director for Stroke Services, Orlando Regional Medical Center

Daniel H Jacobs is a member of the following medical societies: American Academy of Neurology, American Society of Neurorehabilitation, and Society for Neuroscience

Disclosure: Teva Pharmaceutical Grant/research funds Consulting; Biogen Idex Grant/research funds Independent contractor; Serono EMD Royalty Speaking and teaching; Pfizer Royalty Speaking and teaching; Berlex Royalty Speaking and teaching

Francisco Talavera, PharmD, PhD Adjunct Assistant Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Medscape Salary Employment

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