Tremor

• Essential tremor is a type of action tremor that is very common in the general population. It is strongly associated with family history and often shows an autosomal dominant pattern.
• Essential tremor is an action tremor that occurs on movement. It is bilateral - mostly affecting the hands and arms
• Essential tremor is typically absent when the hand/arms are relaxed and supported against gravity
• An essential tremor characteristically improves with a small amount of alcohol. Unlike a physiological tremor, it is not worsened by caffeine
• For a diagnosis of an essential tremor there should be an absence of other neurological signs. The tremor should be long term. Investigations have a limited role in essential tremor, but may be needed when an alternative diagnosis is suspected e.g. parkinson's disease
• Essential tremor is a progressive disease and patients should be warned that symptoms will worsen over time, management options:

  • Propranolol
  • Primidone - anti-epileptic drug