3, 4 There can be considerable variability in the manner in which clinicians assess the presence of tremor and its severity. Though tremor may be the most quantifiable of all movement disorders, there is currently no universally accepted method of rating or measuring tremor. However, such classifications are often problematic as these characteristics can vary greatly within tremor etiologies. 2 In addition to provoking circumstances, other tremor characteristics have been used to try to classify tremor (such as frequency, amplitude, or distribution). ![]() While the tremors encountered in clinical practice are usually involuntary, patients can present with psychogenic tremor in isolation or in combination with other neurologic complaints of psychogenic origin, as in psychogenic parkinsonism. It can also be associated with situations where there is active muscle contraction against a fixed object ( isometric tremor). Kinetic tremor includes task-specific tremor and tremor that is specific to goal-directed movements ( intention tremor). ![]() 2 Action tremor can be further divided into postural or sustention tremor (occurring while maintaining a posture against gravity) and kinetic tremor (occurring during active movement). Rest tremor can be distinguished from other forms of tremor based on its occurrence when the tremoring body part is completely supported against gravity without voluntary muscle contraction, in contrast to action tremor, which occurs with voluntary muscle contraction. Tremor can be most effectively classified based on the circumstances under which it occurs.
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