BENIGN ESSENTIAL TREMOR

BENIGN  ESSENTIAL TREMOR:

This is an idiopathic disorder consisting of an isolated tremor of the hands, head, or both. The lower extremities tend to be spared. Essential tremor can be worsened by the use of caf- feine or beta agonists. Examination reveals no other abnormalities. Although the level of dis- ability tends to be limited, there can be interference with manual skills such as the ability to write. It is characteristic of this disorder that there is an improvement with the use of alcohol. The patient will describe shaky hands, which improve with 2–3 drinks.

There is no specific diagnostic test for this disorder. Treatment is propranolol. If propranolol is ineffective, alternate medications are primidone, alprazolam, and clozapine. If no medical therapy is effective, thalamotomy is indicated.