Neurology

Essential Tremor

본태성진전

Bilateral postural/action tremor, often familial, transiently improved by alcohol

How common
Commonly encountered in neurology
Typical age
Variable age

What is it?

Core pathophysiology of Essential Tremor.

Commonly affected: Affected neural region (peripheral nerve, brain, spinal cord, or muscle)

How it develops

  1. Trigger/predispositionTriggering or predisposing factors for Essential Tremor
  2. Neural injurySpecific nerve/muscle injury occurs
  3. ManifestationCharacteristic neurologic features appear
  4. CourseRecovery or progression depends on treatment

Symptoms

  • Characteristic neurologic symptomClassic Essential Tremor feature
  • Motor/sensory changeWeakness, sensory loss, paresthesia
  • Functional impairmentDifficulty with ADLs

How it is examined

  • Neurologic examStrength, sensation, reflex, cranial nerve, cerebellar
  • Specific testsAppropriate workup for Essential Tremor (NCS/EMG/MRI/serology)

Imaging

Plain X-ray generally not used for diagnosis.

  • N/A

Brain/spine MRI or NCS/EMG as appropriate.

  • Region-specific neurologic findings

Non-surgical care

  • PharmacotherapyDiagnosis-specific neurologic medication
  • Rehab/PTFunctional recovery and maintenance
  • Trigger managementModify identified triggers

Conservative options are generally tried first. Medications listed here can have side effects — discuss them with your prescriber.

When surgery is considered

Refractory or structural abnormality

Procedures that may be discussed

  • Nerve decompression or targeted procedure
  • Immunotherapy/plasmapheresis (if autoimmune)

Outlook

Variable based on timing of diagnosis/treatment; most improve with active care.

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