Age at onset (y) | 55–75 | 10–80 |
Family history | +/– | ++ |
Tremor frequency (Hz) | 4–6 | 5–10 |
Tremor characteristics | Supination–pronation | Flexion–extension |
Influencing factors |
Rest | Increases | Decreases |
Action | Decreases | Increases |
Mental concentration | Decreases | Increases |
Writing | Decreases (micrographia) | Increases (tremulous) |
Walking | Increases | Decreases |
Alcohol | — | Decreases |
Postural tremor | Re-emergent | Without latency |
Kinetic tremor | +/– | Yes |
Limb tremor | Asymmetric | Symmetric |
Distribution other than limbs | Face, jaw, lips, chin | Head, voice |
Neuroimaging—dopaminergic system | Marked dopaminergic deficit | Mild dopaminergic deficit |
Mid-brain sonography | Marked hyper-echogenicity | Mild hyper-echogenicity |
Neuropathology | Nigrostriatal degeneration, Lewy bodies | Mild cerebellar degeneration, Lewy bodies in the substantia nigra, brainstem and cerebellum some cases |
Treatment | Anticholinergics, amantadine, dopaminergic drugs, deep brain stimulation | Alcohol, beta-blockers, primidone, topiramate, gabapentin, botulinum toxin, deep brain stimulation |