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Psychogenic Tremor

Pathophysiology
1. Disappears when not under direct supervision
2. Complex Tremor mimics other Tremor types
Symptoms and Signs
1. Abrupt Tremor onset with static course
2. Spontaneous Tremor remission
3. Tremors difficult to classify
4. Unresponsive to Tremor drugs or response to Placebo
5. Increased with attention
6. Decreased with distraction
7. Absence of other neurologic signs
8. Clinical inconsistencies
Diagnosis
1. Patient taps beat with limb contralateral to affected
2. Psychogenic Tremor suggested if
  1. Tremor decreases in affected limb
  2. Tremor frequency shifts to tapping frequency
Management
1. Psychotherapy
2. Medications not indicated

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This page was written by Scott Moses, MD. This page was last revised before 5/10/08, prior to consistent tracking of revision date. This page was last published on 6/1/2008. Please send comments and questions to the editor. Contact information may be found on the page About the Family Practice Notebook. These pages are best viewed with Microsoft Internet Explorer 6.0.