A 60-YEAR-OLD right-handed man complained of tremor when writing. He had been an accountant for much of his professional life and about 5 years earlier had begun to experience tremor of his right hand only when writing. The tremor gradually worsened, making it difficult to write legibly. Legibility was improved by writing slowly but doing so reduced productivity. He consulted several physicians, who diagnosed essential tremor. Trials of propranolol hydrochloride and primidone did not help. By age 58 years, he was embarrassed by this problem and retired.The problem continued to worsen, but, because the demand for writing was minimal, he could cope. The patient consulted his physician because of difficulty in signing checks. He had no other neurological complaints. Family history of tremor was negative, and examination showed only a problem with writing. There was no tremor at rest, on maintaining a posture, or with the finger-to-nose
Hallett M. Classification and Treatment of Tremor. JAMA. 1991;266(8):1115–1117. doi:10.1001/jama.1991.03470080085035
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: