Tremor (parkinsonian)

Parkinsonian tremor is a 4-8 Hz tremor that is of variable amplitude. It may precede the rigidity of the condition by a time course of months to years. It is usually present when the limb is at rest - 'static tremor' although 50% of patients have a postural component.

Primary features include:

• aggravation by resting, walking, the use of other limbs
• the tremor disappears when the patient is asleep
• a degree of voluntary control over the tremor - the patient may attempt to control it by tightly gripping a rolled up newspaper or another object
• typically, the tremor could be either of,
  • a flexion-extension elbow movement
  • a pronation-supination of the forearm
  • a pill-rolling finger movement. (1)
• rarely the head - flexion and extension; rarely the mandible - rhythmical opening of mouth
• may be unilateral

Reference:

• (1) Tremor fact sheet. National Institute of Neurological Disorders and Stroke National Institutes of Health.2007