Differentiating the Shakes

Essential Tremor v. Parkinson's Disease, Simplified

Of course this topic could be covered in much more depth than shall be covered here... but this is designed to cover the big picture and help you study for the PANCE.

Characteristic: postural and/or intention tremor, meaning when the patient attempts to do something with their arms, the tremor appears or gets worse... these patients have difficulty with eating and drinking. 
Treatment: propranolol and primadone
Other notes: ETOH usually makes tremor BETTER, 50% of pts have a + family hx, tremor can affect voice (remember to ask the pt to say "EEEEEEEEEEE" - you often hear shaking)

Characteristic: resting tremor
Treatment: sinamet, levodopa-carbidopa
Other notes: other PD sx = bradykinesia (slow movements), cog wheeling with passive movements

Source: Hardcore Pathology, by Wahl

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