Slight, usually bilateral postural or kinetic action tremor, particularly in the hands and fingers, is a normal phenomenon and does not indicate a disorder (physiologic tremor ). Physiologic tremor is more intense in situations of stress or anxiety, after strenuous physical work or exercise, or after ingestion of caffeine or other stimulants. More pronounced cases of easily visible and usually reversible tremor without evidence of neurologic disease reflect enhanced physiologic tremor. Usually, nonpharmacologic treatment options are sufficient. However, for some patients, even mild physiologic tremor can lead to large degrees of embarrassment and functional disability, such as the violinist at a decisive audition, or any professional giving an important presentation. The use of a β-blocker (e.g., propranolol) before such a situation may alleviate the tremor, but the optimal dose should be found prior to the important event...other causes should be ruled out consult physicians