Benign Essential Tremor

Question 1

what is benign essential tremor

Answer 1

a fine tremor affecting all the voluntary muscles

Question 2

benign essential tremor is associated with?

Answer 2

old age

Question 3

where is benign essential tremor more noticeable?

Answer 3

It is most notable in the hands but affects many other areas, for example causing a head tremor, jaw tremor and vocal tremor.

Question 4

what are the features of benign essential tremor

Answer 4

Fine tremor
Symmetrical
More prominent on voluntary movement
Worse when tired, stressed or after caffeine
Improved by alcohol
Absent during sleep

Question 5

what are the key differential diagnosis of benign essential tremor?

Answer 5

Parkinson’s disease
Multiple sclerosis
Huntington’s Chorea
Hyperthyroidism
Fever
Medications (e.g. antipsychotics)

Question 6

how do we manage benign essential tremor?
what medications might we use?

Answer 6

no definitive management - tremor not harmful - doesn’t require treatment if not causing functional or psychological problems.
Medications:
Propranolol (a non-selective beta blocker)
Primidone (a barbiturate anti-epileptic medication)