Transcription of UNDERSTANDING Tremor in the Elderly
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UNDERSTANDING Tremor in the Elderly
The Canadian Journal of Diagnosis/ April 200199 UNDERSTANDINGT remor inthe ElderlyBy Joel Hurwitz, MB, FRCPC, FCPT remor is an important and frequent symptom/sign in olderpatients requiring a logical approach to diagnosis. The clinicianshould know the different types of common tremors, keyquestions to ask, practical office examination skills, specific drugtreatments, when to refer the patient for a specialist opinion andthe possible role of andCharacteristics of TremorTremor is defined as a rhythmic, oscillatorytype of involuntary movement. When foundin the Elderly , it needs to be distinguishedfrom: Dystonia (sustained involuntary con-traction); Chorea (rapid, random flowing move-ments); Myoclonus (rapid jerking movements); Akasthisia (subjective state of motorrestlessness usually a consequence ofneuroleptic exposure); and Tardive dyskinesia (mouth, tongue andchewing movements associated with atleast three months of neurolepticexposure).
years, the development of Parkinson’s disease (PD) in some patients. Elderly patients with apparent essential tremor should be closely watched for emergence of
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