Essential Tremor Flashcards
What is an essential tremor?
progressive tremor of upper extremities, present in posture and action without other neurological signs or symptoms
When is the epid of essential tremor?
- Prevalence and incidence increases with age
2. Can be present in early adulthood with FHx
What are RF for essential tremor?
- Advanced age
- FHx
- White ancestry
- Exposure to environmental toxins
What are possible symptoms and signs of an essential tremor?
- Postural and/or kinetic tremor
2. Problems with fine motor tasks
What are possible DDx for essential tremor?
- Parkinson’s disease
- Dystonia
- Wilson’s disease
- Enhanced physiological tremor
- Drug-induced tremor
- Psychogenic tremor
What investigations are used for essential tremor?
- Clinical diagnosis
- Maybe CT or MRI head
- Maybe serum ceruloplasmin but would be normal
What are the two types of management plan for essential tremor?
observation if no dysfunction or embarrassment but if so medical treatment
What medical treatment is used for essential tremor?
1st line: medical treatment e.g. propanol
-beta blockers
-anti-epileptics
-benzodiazpeine
Botulim toxin (head tremors not responsive to medication)
What are the 2nd, 3rd and 4th line treatment for essential tremor?
2nd line: Deep brain stimulation
3rd line: focused US thalamotomy with MRI guidance
4th line: gamma knife thalamotomy
What complications are possible for essential tremor?
- DBS related paresthesia
- DBS related dysarthria
- DBS related gait disorder
What are key differences between parkinsinom and essential tremor?
- high frequency
- symmetrical
- movement / posture
