Tremor

Differential diagnosis

  • Thyroid
  • PD – resting tremor
  • Liver, renal
  • MS
  • Wilsons
  • Essential – most common, 50% familial
  • Anxiety

 

Data gathering

  • Red flags – slow movement, bladder symptoms, rigid
  • Others – resting vs postural, palpitations, bowels, anxiety
  • Examine – DANISH, Gait, CN, PNS

 

Clinical management

  • Investigations
    • Bloods
      • FBC, U+E, LFTs, TFTs, HbA1c
  • Treatment
    • Propranolol (CI: asthma)
  • Followup/Safety-net