Symptoms:

The tremors may affect the hands, arms, head, or eyelids. The tremors rarely affect the lower body and may not affect body sides of the body equally.

The shaking usually involves 6 to 10 movements per second.

The tremors may be:

• Episodic (occuring in discrete bursts)
• Intermittent (come and go with activity, but not always)
• Sporadic (occasional)

They can:

• Disappear during sleep
• Get worse with voluntary movement and emotional stress

Other symptoms may include:

• Head nodding
• Shaking or quivering sound to your voice

Signs and tests:

Your doctor can make the diagnosis by performing a physical exam and asking questions about your medical and personal history, especially your medication use.

A physical exam will show shaking with movement. There are usually no problems with coordination or mental function.

Other tests are usually not needed. However, further tests may be done to rule out other reasons for the tremors. Tremors that occur when the muscles are relaxed or that affect the legs or coordination may be a sign of another condition, such as Parkinson's disease. Other causes of tremors may include:

• Alcohol withdrawal
• Cigarette smoking
• Hyperthyroidism
• Parkinson's disease
• Pheochromocytoma
• Too much caffeine
• Wilson's disease

Blood tests and imaging studies (such as a CT scan of the head, brain MRI, and x-rays) are usually normal.