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Parkinson's disease - Management
How do I differentiate Parkinson's disease from essential tremor?
- If a diagnosis of essential tremor is not clear, refer to a specialist.
- Tremor in Parkinson's disease:
- Is usually unilateral or asymmetrical early in the course of the disease, becoming bilateral as the disease progresses.
- Usually occurs at rest and improves on moving, with mental concentration, and during sleep. However, an action tremor is occasionally present.
- Usually affects the distal part of a limb, typically at the thumb and index finger ('pill-rolling') or the wrist.
- It can also involve the lips, chin, jaw, and legs, but rarely involves the head, neck, or voice.
- Essential tremor:
- Is not usually associated with bradykinesia or postural instability.
- Is usually bilateral and symmetrical.
- Is an action tremor. There is no tremor at rest.
- May worsen with stress, excitement, caffeine, or sleep deprivation.
- Involves the head, neck, or voice as well as the limbs.
- Often improves with alcohol and beta-blockers.
In depth
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