Head (Holocephalic) tremor

Head (Holocephalic) tremor


"... is just an irritation..."
Katherine Hepburn

Etiology
ET
- no-no
- type 1 (enhanced) & 2 (msc activation not req for posture)
- ET meds, if no response botox


PD
- yes-yes
- jaw & lip→ PD

CD
- variable & posturing, pain, sensory trick
- abnormal sensory pathway
- 5y isolated
- botox

Titubation
- cerebellar pathology
- fast
- Vit E deficiency > FA



Physiologic
- can inc w/ sympathatetic activity

Cervical weakness
- no-no
- can occur due to suboccipital muscle weakness (similar isometric)
- usually patient hold the head with the hand

Drug-induced
- rarely causes isolated head tremor

Functional
- change with other movements

Tests
- bMRI and cMRI, if secondary
- EMG if other neuromuscular features