Essential tremor

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Central nervous system

Tremor - essential

The tremors:

• May be occasional (sporadic), temporary (episodic) or occurring at intervals (intermittent)
• Occur at a rate of about 6 to 10 oscillations per second
• May affect the head, hands, arms, eyelids, voice
• Less commonly affect the legs and feet
• May not affect both sides of the body equally
• Worsen with voluntary movement or emotional stress
• Disappear during sleep
• Typically improve with alcohol

There is no laboratory test to diagnose essential tremor. The diagnosis is based on the patient's history, a physical examination revealing tremor on voluntary movement, and no other abnormalities.

However, some testing may be done to rule out other causes of tremors, such as excessive caffeine or tobacco use, alcohol withdrawal, use of certain medications (for example, asthma drugs, lithium, certain antidepressants and anti-seizure drugs), hyperthyroidism, pheochromocytoma, and Wilson's disease.

Routine laboratory tests and brain imaging studies (such as CT scan of the head, brain MRI, and x-rays), or other tests are usually normal.

Review Date: 08/26/2006
Reviewed By: Gail A. Kang, M.D., San Francisco VA Parkinson's Disease Research, Education, & Clinical Center, San Francisco, CA. Review provided by VeriMed Healthcare Network.