20th July 2023

Essential Tremor (ET)

Introduction

The most common movement disorder; is a slowly progressive symmetrical intention tremor of unknown aetiology. It typically affects the upper limbs, head and vocal cords and occurs in those over 40 years old. The tremor tends to improve with alcohol and rest, worsening with anxiety. It is described as an involuntary, rhythmic shaking 5-8Hz, mostly affecting the hands.

Causes

The familial type of this tremor is inherited as an autosomal dominant trait. However, there are also sporadic cases and environmental causes, including heavy metal exposure (usually mercury, manganese and lead), agriculture, pesticides, and glass work. Its pathophysiology involves patchy neuronal loss in the cerebellum.

Diagnosis

Clinical examination and history are common in those over 40 years.

Management

Beta blockers such as propranolol, anti-epileptics, benzodiazepines, botox injections, and primidone.