Benign Essential Tremor

Question 1

What is the typical history associated with benign essential tremors?

Answer 1

Gradual onset of action tremor, often starting in hands. Family history of similar tremors. Tremor worsens with stress, fatigue, caffeine. Improves with alcohol.

Question 2

What are the key physical examination findings in benign essential tremors?

Answer 2

Bilateral, symmetric tremor during voluntary movements. Absence of tremor at rest. No other neurological deficits.

Question 3

What investigations are necessary for diagnosing benign essential tremors?

Answer 3

Clinical diagnosis based on history and physical exam. Rule out other causes of tremor: thyroid function tests, metabolic panel. MRI/CT if atypical features or rapid progression.

Question 4

What are the non-pharmacological management strategies for benign essential tremors?

Answer 4

Lifestyle modifications: avoid caffeine, reduce stress. Occupational therapy for adaptive techniques. Use of weighted utensils or devices.

Question 5

What are the pharmacological management options for benign essential tremors?

Answer 5

Beta-blockers (e.g., propranolol). Anticonvulsants (e.g., primidone). Consider botulinum toxin injections for severe cases.

Question 6

What are the red flags to look for in benign essential tremor patients?

Answer 6

Rapid progression or worsening of tremor. Onset of tremor at rest. Presence of other neurological symptoms.

Question 7

When should a patient with benign essential tremors be referred to a specialist?

Answer 7

Severe or disabling tremor. Poor response to initial treatment. Need for advanced therapeutic interventions (e.g., deep brain stimulation). Uncertain diagnosis.

Question 8

What is one key piece of pathophysiology related to benign essential tremors?

Answer 8

Dysfunction in the central nervous system pathways regulating motor control. Likely involves the cerebellum and thalamus. Genetic factors play a significant role.