tremor in adults - NICE guidance - suspected neurological conditions - recognition and referral
Last edited 05/2019 and last reviewed 05/2022
Tremor in adults
Summary points from NICE guidance relating to tremor in adults are:
Tremor suggesting Parkinson's disease
- refer adults with suspected parkinsonian tremor, other asymmetric tremor, or tremor associated with stiffness, slowness, balance problems or gait disorders for neurological assessment before treatment
Essential tremor
Suspect essential tremor in an adult with symmetrical postural tremor and no symptoms of parkinsonism.
In adults with suspected essential tremor:
- review regular medication
- check thyroid function
- assess alcohol consumption using a tool such as AUDIT (Alcohol Use Disorders Identification Test) - manage if evidence of alcohol misuse/dependence
Refer for neurological assessment only if the symptoms are disabling and first-line treatment as specified in the BNF is ineffective or not tolerated.
Consider referring adults with troublesome tremor of the head to a movement disorder clinic
Reference:
tremor in children - NICE guidance - suspected neurological conditions - recognition and referral