Essential tremor
Summary
Definition
History and exam
Key diagnostic factors
- presence of risk factors
- postural and/or kinetic tremor
- problems with fine motor tasks
Other diagnostic factors
- abatement of tremor after consumption of alcohol, benzodiazepines, barbiturates, or gabapentin
- head or voice tremor
- resting tremor
Risk factors
- advanced age
- family history
- white ancestry
- exposure to environmental toxins
Diagnostic investigations
1st investigations to order
- clinical diagnosis
Investigations to consider
- CT or MRI scan of the head
- serum ceruloplasmin
- 24-hour urine copper
- thyroid function tests
- tremor physiology studies
- single-photon emission CT (SPECT) scan of the head
Emerging tests
- tremor stability index
Treatment algorithm
no dysfunction or embarrassment
dysfunction or embarrassment
Contributors
Authors
Sheng-Han Kuo, MD
H. Houston Merritt Associate Professor of Neurology
College of Physicians and Surgeons
Columbia University
New York
NY
Divulgaciones
SHK is an author of a number of references cited in this topic.
Ming-Kai Pan, MD, PhD
Associate Professor of Pharmacology
College of Medicine
National Taiwan University
Taipei
Taiwan
Divulgaciones
MKP is a consultant of BioPro Scientific, Taiwan, and Sumitomo Pharma Co., Japan. MKP is an author of a number of references cited in this topic.
Agradecimientos
Dr Sheng-Han Kuo and Dr Ming-Kai Pan would like to gratefully acknowledge Dr Zoltan Mari, Dr Martin Kronenbuerger, Dr Adam Burdick, and Dr Kelly D. Foote, previous contributors to this topic.
Divulgaciones
ZM has directed various educational programmes, accredited (CME) by Johns Hopkins University, and has accepted honoraria for consulting. MK, AB, and KDF declare that they have no competing interests.
Revisores por pares
Katherine Longardner, MD
Assistant Clinical Professor
University of California San Diego
San Diego
CA
Divulgaciones
KL was a paid consultant for Boston Scientific.
Roger Weis, MD
Pediatric Neurologist
Kinderneurologisches Zentrum Mainz
Mainz
Germany
Divulgaciones
RW declares that he has no competing interests.
Cory Toth, BSc, MD, FRCP(C)
Assistant Professor of Neurosciences
Hotchkiss Brain Institute
University of Calgary
Alberta
Canada
Divulgaciones
CT declares that he has no competing interests.
Agradecimiento de los revisores por pares
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Divulgaciones
Las afiliaciones y divulgaciones de los revisores por pares se refieren al momento de la revisión.
Referencias
Artículos principales
Deuschl G, Bain P, Brin M; Ad Hoc Scientific Committee. Consensus statement of the Movement Disorder Society on tremor. Mov Disord. 1998;13(suppl 3):2-23. Resumen
Ferreira JJ, Mestre TA, Lyons KE, et al. MDS evidence-based review of treatments for essential tremor. Mov Disord. 2019 Jul;34(7):950-8. Resumen
Zesiewicz TA, Elble RJ, Louis ED, et al. Evidence-based guideline update: treatment of essential tremor: report of the Quality Standards subcommittee of the American Academy of Neurology. Neurology. 2011 Nov 8;77(19):1752-5.Texto completo Resumen
Artículos de referencia
Una lista completa de las fuentes a las que se hace referencia en este tema está disponible para los usuarios con acceso a todo BMJ Best Practice.
Diferenciales
- Parkinson's disease
- Dystonia
- Wilson's disease
Más DiferencialesGuías de práctica clínica
- Suspected neurological conditions: recognition and referral
- American Society for Stereotactic and Functional Neurosurgery position statement on magnetic resonance-guided focused ultrasound for the management of essential tremor
Más Guías de práctica clínicaFolletos para el paciente
Essential tremor
Más Folletos para el paciente
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