Neurology · UKMLA & AKT

Essential tremor

A free high-yield preview for the UKMLA Applied Knowledge Test. Below are the key points to recognise essential tremor — the full SA Note notes add investigations, management, complications and 10 practice questions.

Key high-yield points

  • Bilateral postural and kinetic (action) tremor - absent or minimal at rest; worsens with arms outstretched or on intentional movement
  • Frequency 6-12 Hz - classic exam range 6-8 Hz
  • Functional impairment - writing, using utensils, holding a cup
  • Family history - ~50% of cases; autosomal dominant inheritance
  • Relieved by alcohol - in ~65% of patients
  • Exacerbated by - anxiety, caffeine, adrenergic stimulation
  • Head tremor - horizontal ('no-no') in 75%, vertical ('yes-yes') in 25%

Essential tremor is absent at rest and worsens on action. Parkinson's tremor is most prominent at rest and often improves on intentional movement - the opposite pattern.

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