Essential Tremor Flashcards
1
Q
What is an Essential Tremor?
A
- This is a very common tremor in the general population and its known as a kinetic tremor or postural tremor
2
Q
When can an Essential Tremor be seen?
A
- Tremor seen during voluntary muscle contraction
- Tremor seen during anti-gravity positions (outstretched hands)
3
Q
What is the Pathophysiology of Essential Tremor?
A
- Strong Family History
- Environmental Factors
4
Q
What are the clinical features of an Essential Tremor?
A
- Bilateral kinetic/ Postural Tremor
- Fine Tremor
- Symmetrical
5
Q
What body sites can an essential tremor affect?
A
- Hands
- Arms
- Head
- Voice
- Face
- Trunk
6
Q
How would you describe the Frequency and Amplitude of an Essential Tremor?
A
- Moderate to high-frequency tremor = 6-12 Hz with Low Amplitude
7
Q
What can make an Essential Tremor better?
A
- Alcohol
- Absent during Sleep
8
Q
What can make an Essential Tremor worse?
A
- Tired, Stressed or after Caffeine
- More prominent on voluntary movement
9
Q
What investigation can be done to help distinguish an Essential Tremor from Parkinson’s Disease?
A
- DaTscan - specialised scan that looks for the loss of dopaminergic neurons in the basal ganglia
10
Q
What is the diagnostic criteria for an essential tremor?
A
- Isolated upper limb action tremor
- With/ Without tremor on other sites
- Duration >3 years
- No other neurological features
11
Q
What are the Differential Diagnosis of a Tremor?
A
- Parkinson’s Disease
- Multiple Sclerosis
- Huntington’s Chorea
- Hyperthyroidism
- Fever
- Medications (antipsychotics)
12
Q
What is the Managment for an Essential Tremor?
A
- Propanolol: (beta-blocker to reduce sympathetic activity)
- Primidone: (anti-epileptic drug - activates GABA?)
