title: Case study of a young man with tremor.
abstract: OBJECTIVE
  To provide the clinician with an opportunity to review the most common causes of tremor in young adults.
  
  
  METHODS
  Extensive review of international scientific literature on tremors and other movement disorders, supplemented by a recent case study.
  
  
  CONCLUSIONS
  Essential tremor (ET) is the most common tremor disorder in the world. In contrast to common expectations, the 2nd decade of life represents a period of peak incidence. The early presentation may be so mild that the tremor goes unnoticed by patients and clinicians for many years. The most important movement disorder to rule out in the workup of patients with tremors is Parkinson's disease.
  
  
  CONCLUSIONS
  The diagnosis of ET is generally made on clinical grounds. A comprehensive history and careful physical examination that rules out cerebellar or extrapyramidal disease is required. The clinician must distinguish between resting tremors and action tremors. If the appropriate diagnosis is unclear, a tremor recording (electromyogram) may assist in this distinction. Referral to a neurologist may be warranted.
authors.affiliation: Pediatric Nurse Practitioner Program, Catholic University of America, Washington, DC, USA. Hawkinswalsh@cua.edu
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Hawkins-Walsh
mesh_terms: D000328:Adult; D006801:Humans; D008297:Male; D014202:Tremor / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy