Essential tremor
Epidemiology
- Most common form of tremor
Etiology
- Positive family history
Pathophysiology
Clinical features
- Localization: hands (∼ 90%), head (∼ 30%; "yes-yes” or "no-no” motion), voice (∼ 15%)
- Mostly bilateral postural tremor with a frequency of 5–10 Hz
- Slowly progressive
- Worse with sustained voluntary movement , stress or anxiety, fatigue, and caffeine
- Improves with alcohol consumption
Diagnostics
Tip
Consider an essential tremor in a patient presenting with chronic bilateral hand tremors without further neurological deficits and positive family history.
Treatment
- Drugs of choice:
- Beta blocker: propranolol
- Barbiturates: primidone