CLINICAL DIAGNOSTIC MANUAL
Fine hand tremor is an involuntary, rhythmic, oscillatory movement that affects the hands and can interfere with daily activities such as writing, holding small objects, or eating. This type of tremor is common and can have various etiologies, ranging from physiological causes to pathological disorders. Identifying the underlying cause is crucial to direct appropriate treatment. Tremors can be exacerbated by factors such as stress, fatigue, substance use, or underlying conditions affecting the central or peripheral nervous systems.
Condition | Clinical Symptoms and Signs | Suspected Diagnosis | Confirmatory Diagnosis |
|---|---|---|---|
Thyrotoxicosis | Fine tremor, tachycardia, weight loss, heat intolerance, hyperreflexia | Clinical history, physical exam, signs of hyperthyroidism | Thyroid function tests (TSH, free T4) |
Anxiety | Fine tremor, palpitations, sweating, nervousness, hyperventilation | Clinical history, psychological evaluation | Clinical evaluation, anxiety questionnaires |
Alcohol withdrawal syndrome | Fine tremor, sweating, anxiety, nausea, irritability, hallucinations in severe cases | History of alcohol use, withdrawal symptoms | Clinical history, lab tests (liver function, electrolytes) |
Secondary to sympathomimetic drugs | Fine tremor, tachycardia, hypertension, mydriasis, sweating | History of sympathomimetic drug use | Toxicology tests |
Benign essential tremor | Fine tremor that worsens with action and decreases at rest, no associated neurological symptoms | Family history, clinical history, neurological exam | Clinical diagnosis, exclusion of other causes |
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