Essential Tremor

Timothy C. Hain, MD

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Introduction

Essential tremor (ET) is a common movement disorder in which a high frequency (typically 7 hz) postural tremor occurs in the hands, variably accompanied by a head and/or vocal tremor. The tremor ordinarily is abolished by ingestion of alcohol, and is increased by nervousness and medications that increase adrenalin levels. Essential tremor often runs in families, and is generally not associated with brain lesions.

Unsteadiness is not a prominant part of the essential tremor picture, but occasionally it can accompany the tremor.

Differential Diagnosis:

Essential tremor is generally easily distinguished from the common tremor of Parkinsonism, which is slower and present at rest.

Treatment

Beta blockers such as propranolol, benzodiazepines, and mysoline are all commonly used in treatment. Recently it has been reported that ET can be treated with bilateral thalamic stimulation, but as this procedure is associated with significant morbidity, its usefulness seems very limited.

References:

Pahwa and others. Bilateral thalamic stimulation for the treatment of essential tremor. Neurology 1999:53:1447-1450.