Intentional Tremor Characteristics and Etiologies

Definition and Clinical Presentation

Intentional tremor is characterized by a coarse, irregular tremor that becomes more pronounced during goal-directed movements, often accompanied by a "wing-beating" appearance, particularly evident during finger-to-nose testing 1
The American Academy of Otolaryngology-Head and Neck Surgery notes that intentional tremor can be distinguished from other tremor types by its association with dysarthria (slurred speech) and ataxic gait 1

Wilson's disease presents with a characteristic tremor as part of its neurological manifestations, classified as a "pseudosclerosis dominated by tremor" 1, 2
The American Academy of Otolaryngology-Head and Neck Surgery reports that multiple sclerosis can cause intentional tremor due to demyelinating lesions in cerebellar pathways 3
Traumatic brain injury affecting the cerebellum or its connections can also lead to intentional tremor 3
Certain medications can cause or exacerbate intentional tremor, as noted by the American Academy of Otolaryngology-Head and Neck Surgery 4
Toxic exposures affecting cerebellar function can also contribute to intentional tremor 4

The American College of Radiology distinguishes Parkinsonian tremor from intentional tremor, noting that Parkinsonian tremor is primarily a rest tremor, but can have postural and kinetic components 5
The American College of Radiology also differentiates dystonic tremor from intentional tremor, describing dystonic tremor as irregular and often position-specific 5
The Journal of Hepatology notes that hepatic encephalopathy can cause asterixis or "flapping tremor", which is technically a negative myoclonus 6