Essential tremor causes postural tremor, meaning that it is present on sustained posture and action tremor, which remains rather consistent throughout a movement. It is usually familial and seen in relatives. It typically begins in early adulthood as a fine frequency tremor of the hands. With aging the tremor becomes slower in frequency and increases in amplitude with age. Essential tremor tends to respond to propanolol, primidone and alcohol.
This man describes his day to day problems and social embarassment caused by his tremor. He has a typical coarse head and appendicular tremor seen later with the disorder. Of note, he identifies improvement of his tremor with alcohol intake; some patients may drink to control their tremor to the point of alcohol dependency.
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