Mon–Fri 8AM–5PM · Telehealth Available
VerityMD Neurology accepts new patient referrals by fax: (916) 244-3875
Comprehensive Neurology Evaluation for Hand Tremor, Head Tremor, Voice Tremor, and Shaking
Tremor can affect writing, eating, holding a cup, typing, dressing, work, hobbies, and confidence. Some patients notice hand tremor, while others may have head tremor, voice tremor, leg tremor, internal shaking, or tremor at rest.
VerityMD Neurology evaluates tremor to determine whether symptoms may be related to essential tremor, Parkinson’s disease, medication side effects, thyroid disease, neuropathy, anxiety, dystonia, cerebellar disorders, functional neurological symptoms, or another condition. For eligible patients with Parkinson’s disease or chronic movement disorders, chronic care management support is available.
Symptoms We Evaluate
Hand, head, voice, leg, jaw, or chin tremor
Internal shaking sensation
Resting tremor or action tremor
Tremor while writing, eating, drinking, or using utensils
Tremor with stiffness, slowness, shuffling gait, or balance problems
Tremor with neck pulling or abnormal posture
Tremor with numbness, weakness, neuropathy, or gait instability
Conditions We Help Evaluate or Manage
Essential tremor
Parkinson’s disease
Dystonic tremor
Medication-induced tremor
Enhanced physiologic tremor
Thyroid disease
Neuropathy-related tremor
Cerebellar tremor
Functional neurological tremor
Services and How They Help
Neurology Consultation for Tremor
The evaluation reviews onset, affected body parts, rest versus action tremor, medication history, family history, caffeine effects, thyroid/metabolic issues, walking changes, stiffness, slowness, numbness, weakness, and prior testing.
How this helps:
Clarifies likely tremor type
Distinguishes essential tremor from Parkinson’s disease and other causes
Guides labs, imaging review, medication adjustment, EMG/NCV, therapy, or advanced treatment discussions
Essential Tremor Evaluation
Essential tremor commonly causes shaking during action and may affect hands, head, or voice.
How this helps:
Identifies action tremor pattern
Reviews functional impact
Guides medication, adaptive strategies, and advanced therapy discussions when appropriate
Parkinson’s Disease and Parkinsonian Tremor Evaluation
Parkinson’s disease can cause resting tremor, slowness, stiffness, gait changes, constipation, dream enactment, and facial expression changes.
How this helps:
Looks for parkinsonian features
Assesses movement, tone, gait, and balance
Supports medication and chronic care planning
Chronic Care Management for Parkinson’s Disease
Eligible patients with Parkinson’s disease, parkinsonian symptoms, tremor, gait difficulty, and chronic neurological conditions may receive ongoing support between visits.
How this helps:
Monitors tremor, stiffness, walking, falls, swallowing, sleep, mood, memory, and medication timing
Helps identify wearing-off symptoms and side effects
Improves communication between neurology, primary care, caregivers, and therapists
Medication Review for Tremor
Stimulants, antidepressants, anti-seizure medications, bronchodilators, thyroid medications, steroids, lithium, valproate, dopamine-blocking medications, caffeine, and supplements may contribute.
How this helps:
Identifies medication-related tremor
Reviews dose effects and interactions
Supports safer changes with prescribing clinicians
EMG/NCV Testing for Tremor with Neuropathy or Weakness
EMG/NCV may be helpful when tremor overlaps with numbness, tingling, weakness, imbalance, or suspected neuropathy.
How this helps:
Detects peripheral nerve or muscle contributors
Helps separate tremor from weakness or nerve injury
Supports treatment planning
When Tremor Evaluation & Treatment May Be Helpful
New or worsening tremor
Tremor interfering with daily function
Resting tremor
Tremor with slowness, stiffness, or walking changes
Tremor after medication changes
Tremor with falls, numbness, weakness, or imbalance
What to Bring or Have the Referring Office Send
Referral from PCP, specialist, or referring provider
Medication list, including over-the-counter medications and supplements
Relevant office notes, hospital records, imaging reports, labs, and prior neurological testing if available
Videos of tremor if safely available
Family history of tremor or Parkinson’s disease
List of activities affected by tremor
Prior medication trials for tremor if available
Important Note
This page is for patient education and does not replace individualized medical advice. Testing and treatment decisions should be based on the patient’s history, examination, records, medications, insurance requirements, and clinical judgment.
Emergency Symptoms
Call 911 or go to the nearest emergency department for:
Sudden weakness, facial droop, trouble speaking, or new vision loss
Severe sudden headache or rapidly worsening neurological symptoms
Loss of consciousness, seizure, chest pain, or severe shortness of breath
New inability to walk or sudden severe dizziness with stroke-like symptoms
New Patient Referrals
VerityMD Neurology accepts new patient referrals by fax from the patient’s primary care physician, specialist, or referring provider’s office. To ensure accurate triage, insurance verification, and appropriate scheduling, referrals should be sent directly from the referring provider’s office.
Patients who would like to be seen at VerityMD Neurology should contact their PCP, specialist, or referring provider and ask them to fax a neurology referral with relevant clinical notes, insurance information, medication list, imaging reports, lab results, and prior neurology records if available.
We accept the following insurance
Client Stories
What Our Patients Say
My husband and I are very impressed with the care and professionalism of Dr. Mittal and his staff. Dr. Mittal took time to listen to us - to ask us questions - and to clearly explain the diagnosis and his treatment recommendations. We feel very fortunate - and relieved - to have this neurologist as a member of our care team.
Dr. Manoj Mittal thoroughly understands the complexities of my condition (involving my brain, neck, and nerves) and developed a comprehensive action plan. During my follow-up visit, he carefully assessed my progress to ensure I was staying on track. I had been neglecting a few aspects of my treatment, but he guided me back on course. My treatment involves a team of specialists, multiple surgeries, and personal effort, and I’m truly satisfied with the plan. For the first time in nearly a decade, I feel genuinely hopeful. Thank you, Dr. Manoj Mittal. A+
I was concerned about issues and I called their office. My appointment was not until January and after hearing my concerns, the staff had me scheduled on a Monday, which happens to be two days from when I called voicing my concerns. Nice job.
Dr. Manoj Mittal is an excellent neurologist. He listens carefully, explains everything clearly, and truly cares about his patients. My mom is under his care, and we are very grateful for his expertise and compassion. Highly recommend!
Saw Dr. Mittal and during the first visit he was able to order a few tests that helped diagnose my issue. During the appointment he spent a good amount of time with me and made me feel heard. He was then able to see me again on short notice to help direct me towards next steps, I am very grateful to him.
My 1st appointment with Dr. Mittal, was such a pleasure & surprise. The staff & Dr. Mittal were kind & not in such a hurry. The Dr. took a half hour with me, thoroughly explaining his thoughts & what was to come. Impressed is not a strong enough adjective! Thank you for being a true Doctor who cares.
VerityMD Neurology offers expert neurological care for Sacramento, Carmichael, Folsom, and surrounding communities under the guidance of board-certified neurologist Dr. Manoj Mittal.
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Contact
Phone: (916) 500-4989
Fax Referral: (916) 244-3875
Office Hours
Mon-Fri: 8:00 AM–12:00 PM and 1:00 PM–5:00 PM
Closed for lunch: 12:00 PM–1:00 PM
Sat–Sun: Closed
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