Tremor of the hands alone cannot be diagnosed as Parkinson’s disease. This is because there can be many causes of tremor in the hands. We should first understand that there are many types of tremor. According to the relationship between tremor and random movements, tremor can be divided into the following categories: 1. Resting tremor: It is a rhythmic tremor that occurs at rest or in a state of muscle relaxation, generally with a frequency of 4 to 8 times/second, generally slightly slower and larger in amplitude than simple tremor, and faster and slightly smaller in amplitude than action tremor. It appears at rest and decreases or disappears with movement, and is more pronounced in the distal limbs. Resting tremor is one of the clinical manifestations of Parkinson’s disease. Resting tremor in Parkinson’s disease is often accompanied by increased muscle tone, and “cogwheel-like” or “lead pipe-like” straightening can be found during examination, which is easily detected during head and neck extension and flexion and passive movement of the elbow and wrist joints. The tendon reflexes may be normal, and may not be accompanied by pathological reflexes or sensory disturbances. The site of tremor involvement, frequency and amplitude of tremor are characteristic; whether the tremor affects motor function depends on the severity of the tremor. 2, postural tremor: tremor occurs when the body actively maintains a certain posture, mostly at the distal end of the limb, and the amplitude of the tremor is small and not significantly perceived by the naked eye. Occasionally, the tremor may be slightly obvious during movement, but it is most obvious when a certain posture is fixed. The tremor is generally finer and faster than the resting tremor, with a general frequency of 8 to 12 tremors per second. The following three types of postural tremor are common in clinical practice: (1) Variable physiological tremor. (1) Variable physiological tremor, which is caused by the intensification of physiological tremor. Such as tremor caused by application of epinephrine, hyperthyroidism, pheochromocytoma, hypoglycemia, emotional stress, anxiety, panic, fatigue, etc. It is also seen in cocaine, alcoholism and adverse reactions to certain drugs. It is thought to be related to an increased regulatory response of adrenergic receptors. (2) Familial tremor. It is also called simple tremor or idiopathic tremor. It is a genetically related tremor that can occur at all ages, and the amplitude of the tremor varies with the degree of muscle tension. Tremor is mainly seen in the distal upper extremities, involving the lower extremities less frequently, and can also occur in the mouth, lips, jaw, and tongue. It is important to distinguish it from the resting tremor of Parkinson’s disease and the action tremor caused by cerebellar lesions. (3) Fluttering tremor. It is caused by both basal ganglia lesions and cerebellar ataxia. This type of tremor is coarse, slow rhythm, symmetrical and involves all four limbs, with variable muscle tone. The tremor resembles the fluttering of a bird’s wings, hence the name “wing-like tremor”. It is mainly seen in hepatomegaly, hepatic encephalopathy, uremia and other metabolic encephalopathies. 3, intentional tremor: also known as action tremor. It is a tremor that appears during random movements. Characteristically, the tremor is most pronounced during random movements or when the target is about to be approached, mainly when the cerebellum and its efferent pathways are diseased. Intentional tremor may also not be accompanied by hypotonia, but only appears during limb movement. 4, other tremors: such as hysterical tremor, most of them are action tremors, but there are also those with resting tremors. The tremor is mostly limited to one limb or spreads to the whole body. The amplitude varies, often without a certain pattern. Most of them are coarse and sometimes shaking. When the patient’s attention is distracted, the tremor is often relieved; when the patient focuses on the site of the tremor, the symptoms are more aggravated. There are often psychogenic triggers or other signs of hysteria. Tremor is one of the manifestations of neurological disorders and is a symptom rather than a diagnosis. Tremor and its associated symptoms need to be carefully observed, carefully experienced, and combined with other tests to consider the diagnosis.