II. Pathophysiology

  1. Disappears when not under direct supervision
  2. Complex Tremor mimics other Tremor types
    1. Rest Tremor
    2. Postural Tremor
    3. Kinetic Tremor

III. Symptoms and Signs

  1. Abrupt Tremor onset (often with stressful event) with static course
  2. Spontaneous Tremor remission
  3. Tremor difficult to classify
  4. Unresponsive to Tremor medications or Tremor responds to Placebo
  5. Increased with attention
  6. Decreased with distraction
  7. Absence of other neurologic signs
  8. Clinical inconsistencies and Tremor changes in location and frequency
  9. More common in allied health professionals

IV. Associated Conditions

  1. Somatization Disorder (or multiple undiagnosed subjective concerns)
  2. Psychiatric illness

V. 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

VI. Management

  1. Psychotherapy
  2. Medications not indicated

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Ontology: Psychogenic tremor (C2733359)

Concepts Mental or Behavioral Dysfunction (T048)
SnomedCT 443853005
English Psychogenic tremor (disorder), Psychogenic tremor, psychogenic tremor (diagnosis)
Spanish temblor psicógeno, temblor psicógeno (trastorno), Temblor psicógeno
Czech Psychogenní třes
Dutch psychogene tremor
French Tremblement psychogène
German Psychogener Tremor
Hungarian Psychogen tremor
Italian Tremore psicogeno
Japanese 心因性振戦, シンインセイシンセン
Portuguese Tremor psicogénico