Tremor Exam

 

Exam steps for tremor prompt:

• General inspect

• Characterise tremor straight away - rest, postural, intention

  • Watch at rest, then get them to hold hands out, then straight into finger-nose. ​

• Full upper limb neurological if this was the prompt

• Bradykinesia tests

• Face - inspection, glabellar tap, vertical gaze palsy, nystagmus, speech

• Walk patient

• Move to bed - coordination lower limbs

• Postural blood pressure

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Differentials for tremor:

• Parkinsonian - resting tremor

• Action tremor

  • Thyrotoxicosis​

  • Anxiety

  • Drugs

  • Familial

  • Idiopathic

• Intention tremor (cerebellar)​