Epidemiology

• Most common form of tremor

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Etiology

• Positive family history

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Pathophysiology

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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

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Diagnostics

Tip

Consider an essential tremor in a patient presenting with chronic bilateral hand tremors without further neurological deficits and positive family history.

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Treatment

• Drugs of choice:
  • Beta blocker: propranolol
  • Barbiturates: primidone

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