Chapter 25 Uncommon tremors

Publisher Summary Besides physiological, essential and parkinsonian tremor, there are tremor disorders, which are less common in the clinical routine of neurologists. Nevertheless, these tremors deserve attention, as they may be disabling for the patient. As in the case of drug-induced tremors, they may be quite frequently encountered outside departments of neurology. These “uncommon tremors” are discusses in this chapter. Primary orthostatic tremor is a disorder of middle-aged or elderly persons characterized by a feeling of unsteadiness in the legs and a fear of falling while standing. Holmes' tremor is an infrequent movement disorder, which was first reported by Benedikt in 1889. It has been classified in the past as midbrain tremor, rubral tremor, peduncular tremor, thalamic tremor, Benedikt's syndrome, and myorhythmia. Palatal tremor consists of rhythmic movements of the soft palate. It has also been called: rhythmic palatal myoclonus, oculo-palatal myoclonus, palatal nystagmus, brainstem myorhythmia, or segmental cranial tremor. Other such tremors discussed in this chapter are cerebellar tremor, dystonic tremor, tremor in peripheral neuropathy, drug-induced and toxic tremor syndromes, task- and position-specific tremors, and psychogenic tremor.