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Psychogenic tremors

Department of Neurology, University of Kansas Medical Center, Kansas City, KS (Dr. Koller and B. Vetere-Overfield)
Division of Neurology, Toronto Western Hospital, Toronto, Ontario, Canada (Dr. Lang)
National Neurological Hospital, Queen Square, London, England (Drs. Findley and Cleeves)
Department of Neurology, Albany Medical School, Albany, NY (Dr. Factor)
Department of Neurology, University of Miami, Miami, FL (Drs. Singer and Weiner).

We diagnosed 24 patients, 9 men and 15 women ranging in age from 15 to 78 years, with clinically established or documented psychogenic tremors. Clinical presentations were unique, with complex tremors (often resting, postural, and kinetic), unusual temporal profiles (abrupt onset with a variable course), absence of other neurologic signs, inconsistent and incongruous symptomatology, selective disability with ability to perform some functions despite severe tremors, distractibility that lessens or abolishes tremor, atypical tremorgraphic recordings with changing amplitude and frequency, unusual handwriting and drawing specimens, presence of multiple undiagnosed somatizations, unresponsiveness to all treatments, absence of documented disease by laboratory or radiographic tests, presence of psychiatric disease, spontaneous remissions, or recovery with psychotherapy. We present criteria for the diagnosis of psychogenic tremor.

Address correspondence and reprint requests to Dr. Koller, Department of Neurology, Kansas University Medical Center, 39th and Rainbow Boulevard, Kansas City, KS 66103.

Received November 18, 1988. Accepted for publication in final form February 2, 1989.

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