physiologic tremor

Etiology

• often associated with medications, stress, caffeine, or other triggers

Clinical manifestations

• low amplitude, fast (6-12 Hz) tremor most evident in the fingers & hands when held in a fixed position against gravity.
• fluctuating course the resolves with removal of underlying triggers
• no improvement with alcohol
• little or no functional impairment occurs.

Management

• reassurance
• avoidance of caffeine & other stimulants
• anxiolytics (occasional use)
• propranolol 10-20 mg PO TID
• primidone if propranolol contraindicated

More general terms

• action tremor