Some science behind the scenes

Tremour and its causes

The symptom of tremour can accompany quite a range of disparate illnesses.  Its cause is often misdiagnosed and leads to people being mis-prescribed medication which only serves to make them ill or more ill than they were.

A practical guide to the differential diagnosis of tremor
- Alty JE, Kempster PA; Department of Neurology, Leeds General Infirmary, Leeds, UK
Tremor is, by definition, a rhythmic oscillation of a body part. It is the most prevalent movement disorder in clinical medicine, so doctors working in many specialities and in general practice can expect to encounter it. Most tremors can be classified on the basis of four observable clinical characteristics:

  • anatomical pattern;
  • the relative prominence of the tremor at rest, on maintaining a posture, and with action;
  • tremor frequency;
  • and tremor amplitude.

A resting tremor suggests Parkinson's disease, and the diagnosis then depends on a judgement about whether the patient has other signs of parkinsonism. …….There is a small but genuine diagnostic grey zone between Parkinson's disease and more benign tremor disorders such as essential tremor and dystonic tremor, in which resting and postural tremor coexist with mild or equivocal non-tremor parkinsonian signs.

In effect doctors diagnose a person with Parkinson’s disease, for example, if they have a ‘resting tremour’, but they themselves admit that there are other causes of tremour and there is a lot of room here for error.