intention tremor

Last reviewed 01/2023

Intention tremor describes a tremor which is worse during voluntary movement.

Intention tremor is best seen by asking the patient to touch first their nose, then the examiner's finger, which should be held such that the patient has to nearly fully stretch their arm to touch it. The patient's arm should be thought of as an instrument which amplifies any tremor - thus it is best at full extension.

Alternative ways of demonstrating intention tremor include the 'heel-shin' co-ordination test, and asking the patient to tap quickly and continuously on a hard surface.

The movement seen consists of multiple wrong vectors, i.e. the patient actually moves in the wrong direction. This is distinct from a tremor which imposes a waveform on an otherwise accurate vector.

Typically, this refers to the sort of tremor seen in cerebellar disease. It is most evident when there is damage to the cerebellum's connections to the brainstem.