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Activation classification of tremor

Activation classification of tremor
Tremor type Definition Clinical features and provocative maneuvers
Rest tremor
  Occurs in a body part that is supported in such a way that skeletal muscle activation is neither necessary nor intended. The patient is recumbent on a bed or seated on a chair with the body part supported. Tremor is often enhanced by the performance of cognitive tasks or motor tasks with other body parts, and it is often suppressed, at least temporarily, by voluntary muscle contraction.
Action tremors
Postural Occurs in an attempt to maintain a specific posture or position against the force of gravity. Extending the upper limbs horizontally, pointing at objects, sitting erect without support for the upper body, standing, protruding the tongue.
Kinetic (including simple kinetic, intention, and task-specific tremor) Occurs during any voluntary movement. Intention tremor worsens as the body part approaches its target. Finger-to-nose testing, heel-to-shin testing, reaching, writing, drawing, pouring water into a cup, eating with utensils, speaking. With task-specific tremor, perform the task associated with tremor.
Isometric Occurs during a muscle contraction against a rigid, stationary object. Pushing against a wall, flexing the wrist against a table, making a fist.
Adapted with permission from: Elble RJ. Diagnostic criteria for essential tremor and differential diagnosis. Neurology 2000; 54(suppl 4):S2. Copyright © 2000 Lippincott Williams & Wilkins.
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