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Physiologic Tremor
Aka: Physiologic Tremor, Enhanced Physiologic Tremor
- See Also
- Tremor
- Postural Tremor
- Exam: Findings
- Postural Tremor
- Normal variant (present in most normal patients)
- Example: Hold paper with outstretched arm
- Characteristics
- Low amplitude
- Frequency
- Hands: Rapid (8-12 Hz)
- Other parts: Intermediate (6.5 Hz)
- History: Provocative (Enhanced Physiologic Tremor)
- Emotions (Anxiety, Stress, or Fear)
- Exercise
- Fatigue
- Hypoglycemia
- Hypothermia
- Hyperthyroidism
- Alcohol Withdrawal
- Benzodiazepine Withdrawal
- Medications
- Albuterol
- Caffeine
- Fluoxetine (Prozac)
- Haloperidol (Haldol)
- Tricyclic Antidepressants (e.g. Amitriptyline)
- Lithium
- Methylphenidate (Ritalin)
- Metoclopramide (Reglan)
- Phenylpropanolamine
- Pseudoephedrine
- Synthroid
- Theophylline
- Carbamazepine (Tegretol)
- Valproic Acid
- History: Palliative factors reducing Tremor
- Alcohol
- Benzodiazepines
- Beta Blockers (e.g. Propranolol)
- Primidone (Mysoline)
- Labs: Not indicated unless atypical case or severe Tremor
- Chemistry Panel including Glucose
- Liver Function Tests
- Thyroid Stimulating Hormone (TSH)
- Management
- Eliminate exacerbating factors
- Decrease Caffeine
- References
- Crawford (2018) Am Fam Physician 83(6): 697-702 [PubMed]