Resting tremor vs Intention tremor in the differential diagnosis - USMLE Forums
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Old 03-15-2010
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Default Resting tremor vs Intention tremor in the differential diagnosis

Classically cases have been mentioned in USMLE Step 2 CK exam where the patient is described as either having intention tremor (tremor while the body part is moving) or resting tremor (while the body part is not moving).

The biggest two differential for the CK exam are Parkinson's disease and Benign Essential tremor where the former is resting while the latter is intention.

However, other causes of tremor may not neatly fit into of these two broad categories and you have to look for other clues in the case.

For example, cerebellar tremor although typically seen as intentional (such as the finger nose test) but it's still can be seen during rest or in certain postures. Similarly, physiologic and drug induced tremors can be seen in both situations.

Even benign essential tremor can be seen during rest in severe cases.

So bottom line we should not reliably predict the cause of the tremor on the basis of its categorization as being resting or intention. Except perhaps in the case of idiopathic and drug-induced parkinsonism.
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