Head shaking in the elderly can be considered idiopathic tremor, which is a motor, intentional tremor with a certain genetic predisposition, and about 2/3 of patients will have a family history of the disease. The general age of onset can be between 20 and 30 years old, and 50-60 years old is the high incidence age. Patients will not have other symptoms than head shaking or hand tremor. The disease progresses relatively slowly and generally does not affect the life of the patient. Patients can take oral propranolol to reduce the symptoms after drinking alcohol. For elderly people with head shaking, if accompanied by unstable walking or slow gait, mask face, expression is not rich, we should consider Parkinson’s disease, also belongs to the central nervous system degenerative lesions, patients may also have symptoms of hand trembling in addition to head shaking, resting tremor, rubbing mud ball-like changes, physical examination can be found in the patient’s limbs in the form of gear-like tension changes.