Quick Answer
Timing is diagnostic: essential tremor worsens on action, Parkinsonian on rest —— family and medication history decide next steps.
Medically reviewed by Dr. Jitendra Prasad Yadav • NMC 8029 • Kathmandu Neurology Clinic & Cognitive Center
Direct answer: Hand shaking that worsens when writing, drinking or holding a posture is often essential tremor (frequently familial), while shaking at rest with slowness and stiffness suggests Parkinsonian tremor. Kathmandu Neurology Clinic & Cognitive Center distinguishes these at Durbar Marg, Opposite of Yak & Yeti Hotel by examining rest vs action vs postural components and reviewing medications and thyroid status.
Key points: - Essential tremor: action and postural, may improve with rest; family history in many. - Parkinsonian tremor: classic rest tremor plus bradykinesia and rigidity. - Common mimics: caffeine, bronchodilators, some antidepressants, lithium, valproate, thyroid excess, anxiety, cerebellar disorders.
Dr. Jitendra Prasad Yadav — consultant neurologist & headache specialist at Kathmandu Neurology Clinic & Cognitive Center provides evidence-based evaluation for tremor.
Detailed explanation: Dr. Jitendra Prasad Yadav (NMC 8029) takes detailed tremor history, family, caffeine and medication review, and performs motor examination with gait assessment. Severity is tracked, and reversible contributors are addressed before discussing individualized options. No guaranteed cure is implied.
Bring videos of tremor at rest and on action, family history and medication list to your visit.
Frequently asked questions
Answers reviewed by Dr. Jitendra Prasad Yadav • MBBS, MD (Internal Medicine), FICN (Neurology), FCNV, FIHM • NMC 8029
No. Essential tremor is more common and occurs on action. Parkinsonian tremor is classically at rest with slowness and stiffness. Only examination distinguishes.
Yes, stress, fatigue, and caffeine often amplify tremor amplitude but do not cause the underlying disorder.
No; essential tremor and other conditions also cause tremor and need evaluation.
No; some people present with slowness or stiffness without tremor. Specialist evaluation distinguishes Parkinson's from other causes.
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References & Review
Reviewed by Dr. Jitendra Prasad Yadav • Last reviewed: 2026-09-04
- International Classification of Headache Disorders, 3rd edition (ICHD-3).
- Harrison's Principles of Internal Medicine — Neurology sections.
- American Academy of Neurology guidelines for selected conditions (where applicable).
Content is educational and aligns with standard medical references; individual evaluation may vary. External links provide context and do not imply endorsement.