Postural tremor
A postural tremor is one that is worsened by a particular posture, for example when the arms are outstretched.
It has a variety of causes, for example:
- it may be an exaggerated physiological tremor due to:
- anxiety
- thyrotoxicosis
- metabolic:
- hepatic encephalopathy
- CO2 retention
- brain damage, e.g.:
- Wilson's disease
- syphilis
- essential tremor
- drugs, e.g. salbutamol
- spasmodic torticollis may be exaggerated by certain postures
Notes:
- postural tremor is a position specific tremor occurring when maintaining a specific posture or position (1)
- is considered an action tremor and can be seen in essential tremor (ET), Parkinson's disease and dystonia
- the re-emergent tremor which has been considered a postural tremor in the past, has been found to be a continuation of the rest tremor during stable posturing and tends to be dopamine responsive
- propranolol has been found to be helpful in treating head tremor, by nature considered a postural tremor, in the setting of ET but not dystonia
Reference:
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