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Postural tremor

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

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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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