A patient comes to you because she is experiencing a tremor only when she reaches for things. This becomes worse as she nears the “target.” When you ask her to hold out her hands, no tremor is apparent. What type of tremor does this most likely represent?
A) Intention tremor
B) Postural tremor
C) Resting tremor
D) Nervous tremor
A) Intention tremor
Because this tremor worsens as the target is approached, this represents an “intention” tremor. In this patient, one may suspect cerebellar pathway disease, possibly from multiple sclerosis (one could also look for an intranuclear ophthalmoplegia). A postural tremor occurs when a certain position is maintained, and resting tremors can occur in diseases such as Parkinson's. These do not occur during sleep.
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