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Cerebellar TremorAka: Rubral Tremor, Intention Tremor

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  1. See Also
    1. Kinetic Tremor
  2. Causes
    1. Cerebellar Lesion (CVA or Tumor)
      1. Lesions of lateral cerebellar nuclei
      2. Lesions of cerebellar peduncle
      3. Lesions of red nucleus (Causes Rubral Tremor)
        1. Wing-beating type Tremor
        2. Rubral Tremor also seen in Wilson's Disease
    2. Cerebellar Postural Tremor
      1. Multiple Sclerosis most common etiology
      2. Frequency
        1. Mild: 10 Hz
        2. Severe: 2.5-4 Hz
      3. Amplitude waxes and wanes
    3. Wilson's Disease
    4. Drug-Induced Tremor
      1. Lithium
      2. Alcoholism
    5. Psychogenic Tremor
  3. Symptoms and signs
    1. Intention Tremor on ipsilateral side of lesion
      1. Exacerbated Tremor at end of goal directed movement
      2. Medium frequency Tremor
      3. Example: Finger-nose-finger
      4. Midline disease causes bilateral Tremor
      5. Contrast with Rest Tremor
        1. Rest Tremor improves with goal directed movement
    2. Tremor increases as extremity reaches target
      1. Finger-Nose-Finger
      2. Heel-Knee-Shin
    3. Concurrent Cerebellar signs
      1. Abnormal Gait
      2. Speech abnormalities
      3. Ocular movement abnormalities
      4. Rapid alternating movements abnormal
      5. Abnormal tandem walk (esp. Multiple Sclerosis)
  4. Labs: Directed by suspected diagnosis
    1. Multiple Sclerosis: CSF for IgG gamma globulins
    2. Lithium toxicity: Lithium Level
  5. Radiology
    1. CT Head or MRI Head
  6. Management
    1. Identify Etiology
      1. Rule-out Cerebellar tumor
    2. Multiple Sclerosis
      1. Isoniazid (INH) 600-1200 mg qd
      2. Pyridoxine

Action Tremor (C0234376)

ConceptsSign or Symptom (T184)
MSHD014202
EnglishAction Tremor, Action Tremors, Cerebellar tremor, Hunt's tremor, Intention Tremor, Intention Tremors, Kinetic tremor, Tremor Action, Tremor Intention, Volitional tremor
Spanishtemblor cerebeloso, temblor cinetico, temblor intencional, temblor por accion, temblor volitivo
Parent ConceptsTremor (C0040822)
SourcesCST, DXP, MSH, OMIM, QMR, SCTSPA, SNOMEDCT
Derived from the NIH UMLS (Unified Medical Language System)


Tremor, Rubral (C0750940)

ConceptsSign or Symptom (T184)
MSHD001259
EnglishRubral Tremor, Rubral Tremors
SourcesMSH
Derived from the NIH UMLS (Unified Medical Language System)



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