Approximately 50% of cases are inherited as an autosomal dominant trait

Epidemiology

• Essential tremor (ET) is a common movement disorder.
• The incidence of ET increases with age, may manifest at any age (childhood to adulthood), and those with a positive family history have an earlier age of onset.

Clinical features

• mainly involves upper limbs distally and is postural or kinetic
• tremor amplitude increases with time
• patients experience difficulty with writing, eating, holding objects, fine motor tasks, dressing, speaking
• Tremor often increases with anxiety, stress, and in situations involving interaction with others.
• Patients with head and voice tremor often suffer severe embarrassments, and may develop depression.

Management

The management of a patient with ET includes:

• Behavioural techniques and physical therapy
• Medical (pharmacological) therapy (with agents such as propranolol, primidone, topiramate, gabapentin, clonazepam etc.)