Not usually. Most tremor is not Parkinson's disease. The commonest cause is essential tremor, which occurs during action rather than at rest and affects both hands. Parkinson's tremor is typically present at rest, starts on one side, and comes with slowness.
Not usually. Most tremor is not Parkinson's disease. The commonest cause is essential tremor, which occurs during action rather than at rest and affects both hands. Parkinson's tremor is typically present at rest, starts on one side, and comes with slowness.
Ask when the tremor appears. Essential tremor shows up during activity: holding a cup, writing, bringing a spoon to your mouth. It usually affects both hands roughly equally, often runs in families, and may involve the head or voice. Parkinson's tremor is characteristically present at rest, when the hand is supported and relaxed, and reduces when you reach for something. It typically starts on one side and stays asymmetric for years.
Tremor is neither necessary nor sufficient. The requirement is bradykinesia, meaning slowness with a reduction in movement size, together with either resting tremor or rigidity. A substantial minority of people with Parkinson's never develop tremor at all. Conversely, tremor without slowness generally points elsewhere. Look for the accompaniments: smaller handwriting, quieter voice, reduced facial expression, one arm swinging less when walking, difficulty with buttons.
An overactive thyroid causes tremor and is easily tested. So do a number of common medications and substances: some asthma inhalers, certain antidepressants, lithium, thyroid replacement in excess, and simply too much caffeine. Alcohol excess and alcohol withdrawal both produce it. Anxiety produces a fine tremor that worsens under observation. Bringing a complete medication list including over-the-counter items is genuinely important, because a drug-induced tremor is reversible.
Clinical Neurology Specialists has been physician-owned since 1998, when Leo Germin, M.D., FAANEM founded it. Five board-certified neurologists and four advanced practice providers see patients at the Las Vegas and Henderson offices, each with its own AANEM-accredited electrodiagnostic laboratory.
Clinical Neurology Specialists is an adult outpatient neurology practice for patients 18 and older. The practice performs no surgery and operates no imaging suite, infusion suite or interventional pain programme, and provides no emergency or inpatient care.
Physician-reviewed. Reviewed by the physicians of Clinical Neurology Specialists — board-certified neurologists, AANEM-accredited electrodiagnostic laboratories, physician-owned since 1998. Reviewed 1 August 2026. This article is general education for adults 18 and older and is not a substitute for a consultation.
Sources and further reading: MedlinePlus: Parkinson's disease; National Institute of Neurological Disorders and Stroke; MedlinePlus, National Library of Medicine.
Adults 18 and older, at the Las Vegas and Henderson offices. Call 702-804-1212 or request an appointment online.