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The Curbsiders Internal Medicine Podcast

Supercharge your learning as these board-certified Internists interview the experts to bring you clinical pearls, practice changing knowledge, and a healthy dose of humor. 

Nov 20, 2017

Steady your hand and annihilate tremor with tips from Neurologist, and Movement Disorder specialist, Andres Deik, MD, Assistant Professor of Clinical Neurology at Kashlak Memorial Hospital (we can’t tell you where he really works: ) We teach you to differentiate benign causes of tremor from Parkinson’s disease with simple history and physical exam skills, plus nonpharmacologic and pharmacologic therapies for tremor. Special thanks to Beth Garbitelli and Chris Thrash who wrote and produced this episode and the show notes!

Full show notes available at

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Time Stamps

  • 00:00 Intro and disclaimer
  • 01:08 Listener feedback - Paul is not fired.
  • 02:09 Picks of the week.
  • 05:35 Dr. Deik intro
  • 07:19 Icebreaker questions
  • 12:20 Wikipedia definition
  • 13:02 Classifying tremor
  • 14:33 Postural tremor vs. reemerging rest tremor
  • 15:48 Important history questions
  • 17:58 Medications that can induce tremor
  • 21:39 Physical exam techniques
  • 27:30 Exam characteristics between typical PD tremor and ET
  • 28:36 History components to distinguish between PD and ET
  • 34:10 Misdiagnosis of Parkinson’s
  • 36:54 Imaging workup
  • 39:03 Case from Dr Deik
  • 41:33 Nonpharmacologic management
  • 44:18 Pharmacologic management
  • 49:06 Dosing propranolol
  • 51:07 Distinguishing between physiologic tremor and pathologic tremor’
  • 54:06 Website recommendations
  • 55:50 Handwriting
  • 59:14 Take home points
  • 61:34 Outro

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