Tremor essential

Tremor essential

Essential tremor is a hereditary disease characterized by trembling of the hands, head, and vocal muscles, which increases with movement, an attempt to maintain a certain position and stops when falling asleep. The disease in men usually begins at the age of 50 (in women a little later).

Genetic Aspects

    • Loci 3q 13 (* 190300, 3ql3, genes FET1, ETM1) and 2p25-P22 (* 602134, gene ETM2), R (>50%) were identified
    • Essential tremor with nystagmus and duodenal ulcer (*190310,R).

Clinical picture

    • The disease begins with episodes of rapid (6-12 Hz) paroxysmal (sudden) small-scale tremor of the hands
    • In the future, tremor of the hands, tongue (accompanied by dysarthria), head, legs and torso subsequently develops.
    • Tremor may be unilateral or bilateral, minimal at rest, aggravated by emotional distress, hunger, fatigue, and exposure to extreme temperatures
    • In severe cases, there is a loss of work probability
    • Sometimes tremor is accompanied by mild extrapyramidal disorders in the form of rigidity and gait disturbances, which are much less pronounced than in parkinsonism.
    • Despite impaired workability and possible psychosocial problems, the disease is less severe than parkinsonism, no dementia
    • Often accompanied by dystonia.

Differential Diagnosis

    • Physiological tremor
    • senile tremor
    • Tremor in thyrotoxicosis and alcoholism
    • Tremor in parkinsonism
    • Tremor in cerebellar lesions
    • Tremor during intoxication.


    • Propranolol (anaprilin) ​​20-80 mg 4 r / day (effective also with increased physiological tremor)
    • Primidone 50-250 mg 3 r / day – with ineffectiveness or intolerance to anaprilin
    • Benzodiazepine tranquilizers (diazepam 2–10 mg, lorazepam 1–2.5 mg, oxazepam 10–30 mg orally 3–4 times a day) for increased tremor associated with chronic anxiety
    • A single dose of a small amount of alcohol temporarily reduces the severity of tremor in 50% of patients. The effect begins 10 minutes after administration and lasts 3-4 hours.


    • Tolerance and therapeutic dependence develops to benzodiazepine tranquilizers
    • The use of alcohol to reduce tremors can lead to the development of alcoholism.


    • tremor familial
    • Tremor idiopathic
    • Tremor hereditary
    • Tremor idiopathic benign
    • Tremor Essential benign

See also Tremor, Parkinsonism, Parkinson’s disease, Parkinsonism officinalis ICD. G25.0 Essential tremor



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