{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,6]],"date-time":"2026-10-06T07:19:28Z","timestamp":1791271168531,"version":"4.1.0"},"reference-count":48,"publisher":"Oxford University Press (OUP)","issue":"1031","license":[{"start":{"date-parts":[[2011,6,20]],"date-time":"2011-06-20T00:00:00Z","timestamp":1308528000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2011,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:p>Tremor is, by definition, a rhythmic oscillation of a body part. It is the most prevalent movement disorder in clinical medicine, so doctors working in many specialities and in general practice can expect to encounter it. Most tremors can be classified on the basis of four observable clinical characteristics: anatomical pattern; the relative prominence of the tremor at rest, on maintaining a posture, and with action; tremor frequency; and tremor amplitude. A resting tremor suggests Parkinson\u2019s disease, and the diagnosis then depends on a judgement about whether the patient has other signs of parkinsonism. The most common causes of postural tremor are physiological tremor, essential tremor and drug-induced tremor. The differential diagnosis may also include dystonic tremor and psychogenic tremor, while metabolic tremor caused by thyrotoxicosis should be considered in any recent-onset postural tremor. Wilson\u2019s disease and fragile X-associated tremor\/ataxia syndrome are rarer conditions that may present with tremor and are very important to identify. There is a small but genuine diagnostic grey zone between Parkinson\u2019s disease and more benign tremor disorders such as essential tremor and dystonic tremor, in which resting and postural tremor coexist with mild or equivocal non-tremor parkinsonian signs. The authors review clinical features and investigational techniques that may help to discriminate this group of hard-to-classify tremors.<\/jats:p>","DOI":"10.1136\/pgmj.2009.089623","type":"journal-article","created":{"date-parts":[[2011,6,21]],"date-time":"2011-06-21T05:16:26Z","timestamp":1308633386000},"page":"623-629","source":"Crossref","is-referenced-by-count":34,"title":["A practical guide to the differential diagnosis of tremor"],"prefix":"10.1093","volume":"87","author":[{"given":"Jane E","family":"Alty","sequence":"first","affiliation":[{"name":"Department of Neurology, Leeds General Infirmary , Leeds, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter A","family":"Kempster","sequence":"additional","affiliation":[{"name":"Department of Neurosciences, Monash Medical Centre and Department of Medicine, Monash University , Melbourne, Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2011,6,20]]},"reference":[{"key":"2023041908335709600_b1","doi-asserted-by":"crossref","first-page":"805","DOI":"10.1093\/brain\/117.4.805","article-title":"A study of hereditary essential tremor","volume":"117","author":"Bain","year":"1994","journal-title":"Brain"},{"key":"2023041908335709600_b2","doi-asserted-by":"crossref","first-page":"333","DOI":"10.1016\/j.parkreldis.2006.12.004","article-title":"Essential tremor: phenotypic expression in a clinical cohort","volume":"13","author":"Whaley","year":"2007","journal-title":"Parkinsonism Relat Disord"},{"key":"2023041908335709600_b3","doi-asserted-by":"crossref","first-page":"187","DOI":"10.1016\/S1353-8020(97)00031-X","article-title":"Clinical features of essential tremor seen in neurology practice: a study of 357 patients","volume":"34","author":"Tall\u00f3n-Barranco","year":"1997","journal-title":"Parkinsonism Relat Disord"},{"key":"2023041908335709600_b4","doi-asserted-by":"crossref","first-page":"516","DOI":"10.1002\/lary.20702","article-title":"Clinical characteristics of essential voice tremor: a study of 34 cases","volume":"120","author":"Sulica","year":"2010","journal-title":"Laryngoscope"},{"key":"2023041908335709600_b5","doi-asserted-by":"crossref","first-page":"534","DOI":"10.1002\/mds.22838","article-title":"How common is the most common adult movement disorder? 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