essential tremor

Question 1

aetiology of essential tremor

Answer 1

• aging
• genetics
• env toxins inc lead

Question 2

factors that relieve the essential tremor

Answer 2

Alcohol
Benzodiazepines
Gabapentin
Barbituates

Question 3

features of essential tremor

Answer 3

• worse on intention movements
• bilateral
• hands and arms
• 6-12hz

Question 4

worsening factors for essential tremor

Answer 4

anxiety
excitement
adrenergic stimulation

Question 5

soft neurological signs in some pts with essential tremor

Answer 5

tandom gait
mild cog impairment
slight resting tremor

Question 6

ix for essential tremor

Answer 6

clinical dx
rule out:
* electrolytes and urea
* tft
* ceruloplasmin if suspicious

Question 7

diagnostic criteria for essential tremor

Answer 7

Isolated tremor consisting of bilateral upper limb action tremor, with no other significant motor abnormalities
Greater than 3 years in duration
With/without tremor in other locations (e.g. head, voice, trunk, lower limbs)
Absence of other neurological signs (e.g. dystonia, ataxia, parkinsonism)

Question 8

mx of essential tremor

Answer 8

1. propranolol or primidone
2. gabapentin / topiramate / nimodipine
3. deep brain stimulation
4. botulinum toxin type A injections