Benign essential tremor

Benign essential tremor

Definition

An action tremor without features of parkinsonism.

Aetiology/pathophysiology

Often inherited as an autosomal dominant trait. It tends to present in the teens or in the elderly and affects males and females equally.

Clinical features

A symmetrical, flexion-extension tremor, affecting the hands and head in particular, and sometimes the voice. Oscillations are not usually present at rest, but occur posturally, e.g. holding a newspaper, and are increased by anxiety and movement.

Management

Treatment is often unnecessary, small doses of a β adrenergic blocker such as propranolol or primidone often reduce the tremor. The condition is slowly progressive and may cause some disability.