Essential tremor: a nuanced approach to the clinical features

Abstract

Essential tremor is the most common form of tremor in humans. Given neurologists’ high exposure to this condition, and its seemingly straightforward phenotype, it might seem easy to diagnose. However, 30%–50 % of patients labelled as having ‘essential tremor’ have other diagnoses, mostly Parkinson’s disease and dystonia. The tremor of essential tremor is neither non-descript nor featureless but is multifaceted and highly patterned. This review focuses on its clinical features, beginning with a discussion of tremors and then briefly discussing its additional motor features, and presents several aids to help distinguish essential tremor from Parkinson’s disease and dystonia. Careful attention to certain clinical nuances will aid the diagnosis and care of patients with essential tremor.