Case study of a young man with tremor.

PURPOSE

To provide the clinician with an opportunity to review the most common causes of tremor in young adults.

DATA SOURCES

Extensive review of international scientific literature on tremors and other movement disorders, supplemented by a recent case study.

CONCLUSIONS

Essential tremor (ET) is the most common tremor disorder in the world. In contrast to common expectations, the 2nd decade of life represents a period of peak incidence. The early presentation may be so mild that the tremor goes unnoticed by patients and clinicians for many years. The most important movement disorder to rule out in the workup of patients with tremors is Parkinson's disease.

IMPLICATIONS FOR PRACTICE

The diagnosis of ET is generally made on clinical grounds. A comprehensive history and careful physical examination that rules out cerebellar or extrapyramidal disease is required. The clinician must distinguish between resting tremors and action tremors. If the appropriate diagnosis is unclear, a tremor recording (electromyogram) may assist in this distinction. Referral to a neurologist may be warranted.