Hyperthyroid Tremor

  • Roongroj Bhidayasiri
  • Daniel Tarsy
Part of the Current Clinical Neurology book series (CCNEU)


Normal individuals have a low amplitude and high-frequency physiologic postural tremor of the hands that is usually not visible under ordinary circumstances. There are numerous factors which may increase the amplitude of physiologic tremor, many of which are related to increased sympathetic activity. Drugs which increase tremor by elevating adrenergic activity include beta-adrenergic agonists such as isoproterenol and epinephrine, terbutaline, amphetamines, norepinephrine reuptake inhibitors, tricyclic antidepressants, levodopa, and xanthines such as theophylline and caffeine. Anxiety, fright, excitement, muscle fatigue, hypoglycemia, alcohol and opioid withdrawal, thyrotoxicosis, and pheochromocytoma also enhance adrenergic activity. There are several other drugs and toxins which increase physiologic tremor by uncertain mechanisms such as lithium, corticosteroids, sodium valproate, amiodarone, mercury, lead, and arsenic.


Sympathetic Activity Muscle Fatigue Scalp Hair Motor Finding Sodium Valproate 
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Supplementary material

Hyperthyroid tremor.mp4 (MP4 8,689KB)

The patient displays an irregular high-frequency, low-amplitude tremor of the hands involving left more than right side.


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Copyright information

© Springer Science+Business Media New York 2012

Authors and Affiliations

  • Roongroj Bhidayasiri
    • 1
    • 2
  • Daniel Tarsy
    • 3
  1. 1.Chulalongkorn Center of Excellence on Parkinson’s Disease and Related DisordersChulalongkorn University HospitalBangkokThailand
  2. 2.Department of NeurologyDavid Geffen School of Medicine at UCLALos AngelesUSA
  3. 3.Department of NeurologyHarvard Medical School Beth Israel Deaconess Medical CenterBostonUSA

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