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editorial

. 2017 Aug 26;17(6):456–463. doi: 10.1136/practneurol-2017-001719

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Functional tremor. (A) The tremor affects both hands but there is variation in amplitude and frequency between the right and left spirals. (B) There is a marked discrepancy when the patient copies the spiral in alternate directions. (C) This patient presented with a right (dominant) hand tremor that was consistently unidirectional (8–2 o’clock direction). Other features were variable and inconsistent, suggesting a functional disorder. The site of tremor intrusion changed within a single spiral and between consecutive spirals; the amplitude changed from small to large within a single spiral but there was a consistent amplitude during straight line drawing; while the spirals were drawn quickly, there was freezing of drawing for straight lines. Note the increased density of oscillations, especially on the vertical line drawing.