The authors review clinical features and investigational techniques that may help to discriminate this group of hard-to-classify tremors. There is a small but genuine diagnostic grey zone between Parkinson's disease and more benign tremor disorders such as essential tremor and dystonic tremor, in which resting and postural tremor coexist with mild or equivocal non-tremor parkinsonian signs. Wilson's disease and fragile X-associated tremor/ataxia syndrome are rarer conditions that may present with tremor and are very important to identify. The differential diagnosis may also include dystonic tremor and psychogenic tremor, while metabolic tremor caused by thyrotoxicosis should be considered in any recent-onset postural tremor. The most common causes of postural tremor are physiological tremor, essential tremor and drug-induced tremor. if your voice is wobbly, it goes up and down, usually because you are frightened, not confident, or are going to cry. a wheezy noise sounds as if it is made by someone who has difficulty breathing.
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A resting tremor suggests Parkinson's disease, and the diagnosis then depends on a judgement about whether the patient has other signs of parkinsonism. literary if something such as your voice or smile is tremulous, it is not steady, for example because you are afraid or excited. Most tremors can be classified on the basis of four observable clinical characteristics: anatomical pattern the relative prominence of the tremor at rest, on maintaining a posture, and with action tremor frequency and tremor amplitude. It is the most prevalent movement disorder in clinical medicine, so doctors working in many specialities and in general practice can expect to encounter it. Tremor is, by definition, a rhythmic oscillation of a body part.