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Guest blogger: William G. Ondo, M.D. | April 10, 2017

{Please note that this is for your general education, if you have a tremor that you would like diagnosed you should consult a neurologist specializing in movement disorders.)


While most people are familiar with Parkinson’s disease, essential tremor is much less known, yet actually much more common...8 times more common.


When both diseases are in the early stage, clinical symptoms may not be very pronounced and therefore a definitive diagnosis can be challenging. In fact, Jain et al (2006) observed that one-third of patients who were originally diagnosed as ET were actually misdiagnosed, most commonly with PD. 


In order to begin to understand the differences between the two diseases, first it is important to identify the different types of tremors as defined in Thenganatt and Louis (2012). 


  • Rest tremor occurs when voluntary muscle activity is absent, for example when the arm/hand are dangling down when standing.
  • Action tremor:

o   Postural tremor occurs when holding a body part, such as arm, motionless against gravity.

o   Kinetic tremor occurs with any voluntary movement, such as writing.

o   Intention tremor occurs with goal-directed movement, such as finger to the nose which worsens as the finger approaches the nose.


To distinguish between the two diseases, a neurologist specializing in movement disorders will perform neurological testing and evaluate features of the tremor including frequency, amplitude, pattern and distribution.  Below are the 10 symptoms that distinguish between the two diseases: 


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