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Sirisena D et al. – This article describes some of the important clinical clues that reliably separate tremors, including the rest tremors of Parkinson disease and vascular midbrain lesions, or the action tremors of enhanced physiological tremor, essential tremor and dystonic tremor. Numerous treatment strategies exist for tremor, but focused, selective use of appropriate medications requires accurate clinical diagnosis. Diagnostic certainty is essential as functional neurosurgery (deep brain stimulation) offers a realistic treatment option for many patients with severe tremor.


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