Essential Tremor and involuntary Movements

Question 1

What are the types of tremor

Answer 1

1. Physiological tremor
2. Essential tremor
3. Resting tremor
4. Intention tremor

Question 2

Features of essential tremor

Answer 2

Autosomal dominant
Most commonly involuntary movement disorder
Benign essential tremor
Most commonly seen >70yo

Question 3

Clinical features of essential tremor

Answer 3

Rapid postural tremor of the upper extremities: Seen when skeletal muscle is holding a position against gravity
Bilateral and symmetric
Head (titubation) and/or speech
Worsens with stress and improves with alcohol
Neurological exam will be otherwise normal

Question 4

Management for essential tremor

Answer 4

Propranolol is first-line
primidone is sometimes used

Surgical intervention for severe cases, including deep brain stimulation, focused ultrasound thalamotomy, and radiosurgical (Gamma Knife) thalamotomy.