How do tremors most commonly present in Parkinson's disease?

How do tremors most commonly present in Parkinson's disease?

• A. Action tremor that can be present years before the pill-rolling tremor, usually unilateral
• B. Tremor that is bilateral from onset
• C. Tremor that disappears with movement
• D. Tremor limited to the lips

Answer: (A)

Parkinsonian tremor is classically a rest tremor that begins on one side and may precede other motor symptoms. It is often described as a pill-rolling tremor and is most evident when the limb is at rest. A hallmark feature is that it diminishes or disappears with intentional movement, meaning the tremor is not present during purposeful action. This unilateral onset early in the disease can later become bilateral as Parkinsonism progresses. Tremor limited to the lips is not typical, and bilateral onset from the start is less common in early disease. So the most characteristic presentation is a rest tremor that fades with movement, usually starting unilaterally.

Parkinsonian tremor is classically a rest tremor that begins on one side and may precede other motor symptoms. It is often described as a pill-rolling tremor and is most evident when the limb is at rest. A hallmark feature is that it diminishes or disappears with intentional movement, meaning the tremor is not present during purposeful action. This unilateral onset early in the disease can later become bilateral as Parkinsonism progresses. Tremor limited to the lips is not typical, and bilateral onset from the start is less common in early disease. So the most characteristic presentation is a rest tremor that fades with movement, usually starting unilaterally.