Task Specific Tremors.

A patient reported bilateral hand tremors when writing but not with other tasks. These "task specific" tremors are considered subcategories of essential tremor. Primary writing tremor, in which the tremor occurs only with writing, is probably the most common. The important teaching point is that the "standard" tremor assessment, watching the patient holding a sustained posture and touching his finger to the examiner's and then back to the nose is not adequate. Patients should be tested doing the activity that causes them the most difficulty.