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Rest Tremor

  • Giuliana Grimaldi
  • Mario Manto
Chapter
Part of the Contemporary Clinical Neuroscience book series (CCNE)

Abstract

By definition, rest tremor is an involuntary oscillation occurring while the body segment is maintained at rest, fully supported against gravity. To look for a rest tremor, the patient is seated with the upper limbs relaxed and the forearms on the thighs, or the patient is lying horizontally in complete repose. Rest tremor is typically in the 3–6 Hz frequency range (Fig. 7.1) and may reach high levels of severity. Rest tremor is usually asymmetrical, in general starting distally in the arms and legs. Typically, tremor in the upper limbs reminds the “pill rolling” movement. Lips and jaw can be affected, with a rhythmic clicking of teeth. Head and trunk are usually spared. Rest tremor may disappear or subside with action (posture, movement, maintaining an isometric force, exerting a specific task) and is associated with reciprocal activation in antagonistic muscles. In some cases, patients can reduce the tremor by holding one hand with the other or crossing the legs. Rest tremor often increases with mental stress (i.e. counting backwards) or contralateral motion (Froment manoeuvre). However, this feature is not specific. Rest tremor disappears during sleep, as most tremulous disorders.

Keywords

Rest Frequency Parkinson’s disease Cortico–subthalamo–pallido–thalamic loop Dopamine Levodopa Dopamine agonists Anticholinergic 

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Copyright information

© Springer Science+Business Media New York 2013

Authors and Affiliations

  1. 1.Unité d’Etude du Mouvement (UEM), Neurologie ULB ErasmeBruxellesBelgium

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